Individual provider Active NPI

Mark Hnatiuk, MD

  • Otolaryngology Physician
  • Novi, MI
National Provider Identifier
1487631180
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301074049 Issued in MI
Practice address
26850 Providence Parkway
Suite 205
Novi, MI 48374-1252
Phone
(248) 465-5314
Fax
(248) 465-5301
NPI assigned
Dec 23, 2005
Last updated
Jun 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4301074049 MI Primary
Facial Plastic Surgery Physician 207YS0123X 430107409 MI

Addresses

Primary practice location

26850 Providence Parkway
Suite 205
Novi, MI 48374-1252

Mailing address

26850 Providence Parkway
Suite 205
Novi, MI 48374-1252
Phone (248) 465-5314

Other identifiers 1

IdentifierTypeStateIssuer
389063649-00OtherOHBWC

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 Medicine

State licenses

LicenseStateTypeSpecialty
430107409MIMDFacial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose and Throat Consultants PC PastSince Mar 18, 2013 Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients
ENT Physicians,P.C Otolaryngology Past Accepting new patients
ENT Physicians Inc Otolaryngology PastSince Sep 1, 2020 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1487631180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PARKWAY",
            "address_2": "SUITE 205",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741252",
            "telephone_number": "248-465-5314",
            "fax_number": "248-465-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PARKWAY",
            "address_2": "SUITE 205",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741252",
            "telephone_number": "248-465-5314",
            "fax_number": "248-465-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HNATIUK",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301074049",
            "primary": true
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MI",
            "license": "430107409",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "389063649-00",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.