Individual provider Active NPI

Matthew Thomas Stepanovich, M.D.

  • Orthopaedic Surgery Physician
  • Ann Arbor, MI
National Provider Identifier
1346477676
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301117356 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Jun 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 129788 CA
Pediatric Orthopaedic Surgery Physician 207XP3100X 4301117356 MI
Orthopaedic Surgery Physician 207X00000X 4301117356 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

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
I20190815000340 MI Practitioner - Orthopedic SurgeryPractitioner - Pediatric Medicine 5890017727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Pediatric Medicine
Education
Michigan State University College of Human Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1051 N Canton Ctr Rd
Canton, MI 48187-5097
Phone (734) 936-5780

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-5780

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129788CAMDOrthopaedic Surgery Physician
4301117356MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc Orthopaedic Surgery Current Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Jun 15, 2020 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Jun 15, 2020 Accepting new patients
Regents of the University of Michigan CurrentSince Aug 8, 2019 Accepting new patients
Regents of the University of Michigan Orthopaedic Surgery CurrentSince Aug 8, 2019 Accepting new patients
Regents of the University of Michigan Past Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Fl 3
Ann Arbor, MI 48109
Phone (734) 647-5944

1500 E Medical Center Dr
Fl 4
Ann Arbor, MI 48109
Phone (734) 763-9259

7500 Challis Rd
Brighton, MI 48116
Phone (734) 764-4190

7500 Challis Rd
Fl 1
Brighton, MI 48116
Phone (810) 263-4000

1051 N Canton Center Rd
Canton, MI 48187
Phone (734) 647-5670

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

39901 Traditions Dr
Ste 110
Northville, MI 48168
Phone (248) 305-4400

Interoperability endpoints

  • Direct secure messaging: matthew.stepanovich.1@8233.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1244851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1346477676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPANOVICH",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-13",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "129788",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "MI",
            "license": "4301117356",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301117356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.