Individual provider Active NPI

Steven D Daveluy, MD

  • Dermatology Physician
  • Dearborn, MI
National Provider Identifier
1467611475
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
4301092700 Issued in MI
Practice address
18100 Oakwood Blvd
Suite 300
Dearborn, MI 48124-4085
Phone
(313) 240-4900
Fax
(313) 429-7931
NPI assigned
Jun 4, 2008
Last updated
Dec 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 4301092700 MI Primary

Addresses

Primary practice location

18100 Oakwood Blvd
Suite 300
Dearborn, MI 48124-4085

Mailing address

1560 E Maple Rd
Suite 400 - Credentialing
Troy, MI 48083-1138
Phone (313) 240-4900

Other practice location 1

5250 Auto Club Dr Ste 290A
Dearborn, MI 48126-2619
Phone (313) 448-9220

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
I20120725000958 MI Practitioner - Dermatology 1254597818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Wayne State University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

5250 Auto Club Dr
Suite 290a
Dearborn, MI 48126-2619
Phone (313) 488-9220

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions91
Removal or shaving of skin growth1-10
Skin biopsy41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301092700MIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group CurrentSince Aug 15, 2012 Accepting new patients
University Physician Group Dermatology CurrentSince Aug 15, 2012 Accepting new patients
University Physician Group Past Accepting new patients
University Physician Group Past Accepting new patients

Locations

5250 Auto Club Dr
Ste 290A
Dearborn, MI 48126
Phone (313) 240-4900

18100 Oakwood Blvd
Ste 300
Dearborn, MI 48124
Phone (313) 240-4900

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

4646 John R St
Detroit, MI 48201
Phone (313) 576-3389

1560 E Maple Rd
Ste 400
Troy, MI 48083

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

Interoperability endpoints

  • Direct secure messaging: sdaveluy@direct.dmc.org
  • Direct secure messaging: steven.daveluy.1@19711.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1467611475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400 - CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "313-240-4900",
            "fax_number": "313-429-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18100 OAKWOOD BLVD",
            "address_2": "SUITE 300",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244085",
            "telephone_number": "313-240-4900",
            "fax_number": "313-429-7931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5250 Auto Club Dr Ste 290A",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481262619",
            "country_code": "US",
            "telephone_number": "313-448-9220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVELUY",
        "first_name": "STEVEN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-04",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301092700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.