Individual provider Active NPI

Jonathan Robert Sorini, D.O.

  • Emergency Medicine Physician
  • Dearborn, MI
National Provider Identifier
1417120098
Registry record updated Jul 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101017369 Issued in MI
Practice address
18101 Oakwood Blvd
Emergency Dept
Dearborn, MI 48124-4089
Phone
(313) 593-8780
Fax
(313) 436-2864
NPI assigned
Apr 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X L1152636 MI
Emergency Medicine Physician 207P00000X 5101017369 MI Primary

Addresses

Primary practice location

18101 Oakwood Blvd
Emergency Dept
Dearborn, MI 48124-4089

Mailing address

38935 Ann Arbor Rd
Credentialing Dept
Livonia, MI 48150-3397
Phone (734) 632-0175

Other identifiers 2

IdentifierTypeStateIssuer
1417120098MedicaidMI
12401050OtherMICAQH

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
I20120720000102 MI Practitioner - Emergency Medicine 1153587019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
58.74 of 100Reported as individual
Quality
30
Improvement activities
40
Cost
57.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101017369MIMDEmergency Medicine Physician
L1152636MIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Michigan, P.C. Emergency Medicine CurrentSince May 1, 2014 Accepting new patients

Locations

7300 N Canton Center Rd
Canton, MI 48187
Phone (734) 454-8001

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

18101 Oakwood Blvd
Ste 103G
Dearborn, MI 48124

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Organizations & group practices 1

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": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1417120098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38935 ANN ARBOR RD",
            "address_2": "CREDENTIALING DEPT",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503397",
            "telephone_number": "734-632-0175",
            "fax_number": "734-632-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "address_2": "EMERGENCY DEPT",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-8780",
            "fax_number": "313-436-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORINI",
        "first_name": "JONATHAN",
        "middle_name": "ROBERT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-04",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "L1152636",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101017369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417120098",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12401050",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.