Individual provider Active NPI

Larry A Adler, M.D.

  • Gastroenterology Physician
  • Ypsilanti, MI
National Provider Identifier
1356320634
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
048783 Issued in MI
Practice address
5300 Elliott Dr
Ypsilanti, MI 48197-8632
Phone
(734) 434-6262
Fax
(734) 712-2820
NPI assigned
Jan 13, 2006
Last updated
Jan 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 048783 MI Primary

Addresses

Primary practice location

5300 Elliott Dr
Ypsilanti, MI 48197-8632

Mailing address

5300 Elliott Dr
Ypsilanti, MI 48197-8632
Phone (734) 434-6262

Other identifiers 7

IdentifierTypeStateIssuer
100003582OtherMIMEDICARE RAILROAD PTAN
4404026OtherMIAETNA
0H14989OtherMIBCBS GROUP
022067OtherMIMIDWEST HEALTH PLAN
0810209OtherMIBCBS INDIVIDUAL
2346967001OtherMICIGNA
1985244MedicaidMI

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
I20051227000514 MI Practitioner - Internal MedicinePractitioner - Gastroenterology 7315935707 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048783MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Mercy Hospital Crna Current Accepting new patients
Huron Gastroenterology Associates PC Gastroenterology CurrentSince Jul 1, 1999 Accepting new patients
Huron Gastroenterology Associates PC Gastroenterology CurrentSince Jul 1, 1999 Accepting new patients
St Mary Mercy Hospital Professional Gastroenterology CurrentSince Sep 16, 2023 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
St Mary Mercy Hospital Professional Current Accepting new patients
Huron Gastro Endoscopy Center LLC Current Accepting new patients
St Mary Mercy Hospital Current Accepting new patients
Iha Health Service Corporation CurrentSince Jul 30, 2021 Accepting new patients
Iha Health Service Corporation Gastroenterology CurrentSince Jul 30, 2021 Accepting new patients

Locations

1600 S Canton Center Rd
Canton, MI 48188
Phone (734) 398-7557

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

20555 Victor Pkwy
#3A
Livonia, MI 48152

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

36650 5 Mile Rd
Livonia, MI 48154
Phone (734) 434-6262

36650 5 Mile Rd
Ste 101
Livonia, MI 48154
Phone (734) 434-6262

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5300 Elliott Dr
Ypsilanti, MI 48197
Phone (734) 434-6262

5325 Elliott Dr
Ste 201
Ypsilanti, MI 48197
Phone (313) 434-6262

5333 McAuley Dr
Rm 2115
Ypsilanti, MI 48197
Phone (734) 712-3971

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 11

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1356320634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 ELLIOTT DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978632",
            "telephone_number": "734-434-6262",
            "fax_number": "734-712-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 ELLIOTT DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978632",
            "telephone_number": "734-434-6262",
            "fax_number": "734-712-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADLER",
        "first_name": "LARRY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "048783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "100003582",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4404026",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0H14989",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH PLAN",
            "identifier": "022067",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "0810209",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2346967001",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1985244",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.