Active NPI
Jerry Uzansky, D.O.
- Family Medicine Physician
- Detroit, MI
National Provider Identifier
1477523892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- GU005238
- Practice address
- 4771 Michigan Ave
Detroit, MI 48210-3247 - Phone
- (313) 897-2600
- Fax
- (313) 897-2424
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | GU005238 | MI | Primary |
Addresses
Primary practice location
4771 Michigan Ave
Detroit, MI 48210-3247
Mailing address
4771 Michigan Ave
Detroit, MI 48210-3247
Phone (313) 897-2600
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01030002 | Other | MI | MEDICARE INDIVIDUAL #S |
| 1117993 | Medicaid | MI | |
| 0258220204 | Other | MI | BCBS NUMBER |
| 0P01030 | Other | MI | MEDICARE GROUP NUMBER |
| 1477523892 | Other | MI | NPI INDIVIDUAL |
| 1285813154 | Other | MI | NPI GROUP NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GU005238 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sciometrix Inc | Current | Accepting new patients |
Locations
306 S Washington Ave
Ste 600
Royal Oak, MI 48067
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.
-
- General Practice Physician
- Staten Island, NY
- NPI 1457065591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193616000000",
"number": "1477523892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4771 MICHIGAN AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482103247",
"telephone_number": "313-897-2600",
"fax_number": "313-897-2424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4771 MICHIGAN AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482103247",
"telephone_number": "313-897-2600",
"fax_number": "313-897-2424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UZANSKY",
"first_name": "JERRY",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2007-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "GU005238",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE INDIVIDUAL #S",
"identifier": "P01030002",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1117993",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NUMBER",
"identifier": "0258220204",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "0P01030",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI INDIVIDUAL",
"identifier": "1477523892",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI GROUP NUMBER",
"identifier": "1285813154",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.