Individual provider Active NPI

Earl Gerald Garcia Carlos, DO

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1336595040
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101022805 Issued in MI
Practice address
13901 E Jefferson Ave
Detroit, MI 48215-2720
Phone
(331) 382-1259
Fax
(313) 822-2599
NPI assigned
May 11, 2016
Last updated
Sep 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.152147 IL
Family Medicine Physician 207Q00000X 5101022805 MI Primary

Addresses

Primary practice location

13901 E Jefferson Ave
Detroit, MI 48215-2720

Mailing address

13901 E Jefferson Ave
Detroit, MI 48215-2720
Phone (331) 382-1259

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240819001545 MI Practitioner - Family Practice 9830520493 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Nova Southeastern College of Osteo Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

13901 E Jefferson Ave
Detroit, MI 48215-2720
Phone (313) 822-0900

611 Martin Luther King Jr Blvd
Detroit, MI 48201-2273
Phone (313) 832-6300

6550 W Warren Ave
Detroit, MI 48210-1134
Phone (313) 897-7700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036.152147ILMDFamily Medicine Physician
5101022805MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Family Medicine CurrentSince Aug 10, 2024 Accepting new patients
Sciometrix Inc CurrentSince Feb 21, 2026 Accepting new patients
Detroit Community Health Connection, Inc CurrentSince Apr 3, 2025 Accepting new patients
Detroit Community Health Connection, Inc. CurrentSince Apr 3, 2025 Accepting new patients
Partners in Wellness Family Medicine Past Accepting new patients
Detroit Wayne County Health Authority PastSince Jul 6, 2020 Accepting new patients

Locations

13901 E Jefferson Ave
Detroit, MI 48215
Phone (313) 821-2591

400 Mack Ave
Detroit, MI 48201
Phone (313) 448-9006

400 Mack Ave
Ste 2E
Detroit, MI 48201

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

611 Mlk Blvd
Detroit, MI 48201
Phone (313) 832-6300

6550 W Warren Ave
Detroit, MI 48210
Phone (313) 897-7700

306 S Washington Ave
Ste 600
Royal Oak, MI 48067

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

Interoperability endpoints

  • Direct secure messaging: earl.gerald.carlos.1@16555.direct.athenahealth.com
  • Direct secure messaging: ecarlos1079867@direct.hfhs.org
  • FHIR API: https://api.platform.athenahealth.com/19827/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1336595040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13901 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152720",
            "telephone_number": "331-382-1259",
            "fax_number": "313-822-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13901 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152720",
            "telephone_number": "331-382-1259",
            "fax_number": "313-822-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLOS",
        "first_name": "EARL GERALD",
        "middle_name": "GARCIA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-11",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.152147",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101022805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.