Individual provider Active NPI

Mark Peter Schury, D.O.

  • Family Medicine Physician
  • Waterford, MI
National Provider Identifier
1376510099
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MS013623 Issued in MI
Practice address
4400 Dixie Hwy
Suite B
Waterford, MI 48329-3508
Phone
(248) 673-1244
Fax
(248) 673-0114
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MS013623 MI Primary

Addresses

Primary practice location

4400 Dixie Hwy
Suite B
Waterford, MI 48329-3508

Mailing address

4400 Dixie Hwy
Suite B
Waterford, MI 48329-3508
Phone (248) 673-1244

Other identifiers 1

IdentifierTypeStateIssuer
0856306175OtherMIBCBSM

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
I20101028000848 MI Practitioner - Family Practice 3971797465 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MS013623MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Integrated Healthcare Network Current Accepting new patients
McLaren Oakland Family Medicine CurrentSince May 26, 2010 Accepting new patients
McLaren Oakland CurrentSince May 26, 2010 Accepting new patients
Oakland Integrated Healthcare Network CurrentSince Jan 1, 2023 Accepting new patients
Oakland Integrated Healthcare Network CurrentSince Jan 1, 2023 Accepting new patients
McLaren Oakland Family Medicine Current Accepting new patients

Locations

8172 Reliable Pkwy
Chicago, IL 60686
Phone (517) 908-0847

1701 Baldwin Ave
Ste 102
Pontiac, MI 48340
Phone (248) 334-4962

1701 Baldwin Ave
Pontiac, MI 48340
Phone (248) 334-4962

950 University Dr
Pontiac, MI 48342
Phone (248) 334-0947

461 W Huron St
Ste 107
Pontiac, MI 48341
Phone (248) 857-7432

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

4400 Dixie Hwy
Ste B
Waterford, MI 48329
Phone (248) 673-1244

Interoperability endpoints

  • Direct secure messaging: mark.schury.p1@direct.oihn.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1376510099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 DIXIE HWY",
            "address_2": "SUITE B",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293508",
            "telephone_number": "248-673-1244",
            "fax_number": "248-673-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 DIXIE HWY",
            "address_2": "SUITE B",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293508",
            "telephone_number": "248-673-1244",
            "fax_number": "248-673-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHURY",
        "first_name": "MARK",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "MS013623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0856306175",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.