Mark Leo McDermott, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4301054291 Issued in MI

Practice address

Kresge Eye Institute
4717 St Antoine
Detroit, MI 48201

Phone

(313) 577-8900

Fax

(313) 577-0700

NPI assigned

Jun 1, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

University of Wisconsin School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health Macomb Oakland HospitalGroup PAC ID 7315859725, 155 clinicians

University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.mcdermott.1@19711.direct.athenahealth.com
• Direct secure messaging: mmcdermo@direct.dmc.org
• Direct secure messaging: mmcdermott1140869@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Henry Ford Health Macomb-Oakland Hospital

  • Family Medicine Physician
  • Warren, MI
  • NPI 1134176472

  Ophthalmology

  Medicare reassignment Care Compare group NPD
• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797

  Ophthalmology

  Medicare reassignment Care Compare group NPD
• Henry Ford Health Macomb-Oakland Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD
• Henry Ford Health Macomb Oakland Hospital

  • Psychiatric Hospital Unit
  • Warren, MI
  • NPI 1306816426
  NPD (past)
• University Physician Group

  • Social Worker
  • Livonia, MI
  • NPI 1154360402
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1326085820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 EAST MAPLE ROAD",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831189",
            "telephone_number": "248-581-5976",
            "fax_number": "248-581-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KRESGE EYE INSTITUTE",
            "address_2": "4717 ST ANTOINE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-577-8900",
            "fax_number": "313-577-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "MARK",
        "middle_name": "LEO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301054291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Elena McCusker, CRNA
• Carynton Lauriel McDaniel
• Crystal Lachonne McDaniel
• Jasmine McDaniel
• Meagan McDavid, M.D.
• Ashley Beverly Reshea McDonald
• Cecelia McDonald
• Corey McDonald
• Daniel William McDonald, CPRC
• Kenneth McDonald, LMSW

• Ophthalmology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.