Michael Eric Degryse, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101024461 Issued in MI

Practice address

36475 Five Mile Rd
Livonia, MI 48154-1971

Phone

(734) 655-4800

Fax

(734) 655-8430

NPI assigned

Apr 10, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Professional Emergency Care, PC

  • Emergency Medicine Physician
  • Clinton Township, MI
  • NPI 1326235698
  Medicare reassignment NPD

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1386030930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9730 BUNTON RD",
            "city": "WILLIS",
            "state": "MI",
            "postal_code": "481919625",
            "telephone_number": "734-732-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36475 FIVE MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541971",
            "telephone_number": "734-655-4800",
            "fax_number": "734-655-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRYSE",
        "first_name": "MICHAEL",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-10",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101024461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Anthony Decarlo, TLLP
• Patricia Irene Decourcy, MSW LMSW
• Belinda Deem
• Amira Mohamad Deep-Berry, NP
• Deering Street Community Living & Respite Center LLC
• Mohammad Mahdi Dehbozorgi, M.D.
• Jeffrey P Dehn, MPT
• Kevin G. Deighton, MD
• Fanny Aguirre Dela Cruz, M.D.
• Daniel R Delcastillo, CCP

• Emergency Medicine Physician in Livonia, MI
• Providers in Livonia, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.