Individual provider Active NPI

Michael Blair Deyoung, D.O.

  • Cardiovascular Disease Physician
  • Mount Clemens, MI
National Provider Identifier
1487861043
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
5101014995 Issued in MI
Practice address
1000 Harrington Blvd.
Mount Clemens, MI 48043-2920
Phone
(586) 493-8000
NPI assigned
May 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 5101014995 MI Primary

Addresses

Primary practice location

1000 Harrington Blvd.
Mount Clemens, MI 48043-2920

Mailing address

413 Moran Rd
Grosse Pointe Farms, MI 48236-3212
Phone (313) 885-6119

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
I20080626000676 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5799857363 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren MacombGroup PAC ID 8921912791, 131 clinicians
McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians
McLaren OaklandGroup PAC ID 0547173213, 51 clinicians

Practice addresses (Care Compare)

1000 Harrington St
Mount Clemens, MI 48043-2920
Phone (810) 493-8000

1030 Harrington St
Mount Clemens, MI 48043-2967

1030 Harrington St
Suite Ll001
Mount Clemens, MI 48043-2918
Phone (586) 493-3297

21510 Harrington St
Clinton Township, MI 48036-2378

37399 Garfield Rd
Clinton Township, MI 48036-3672

5210 Highland Rd
Suite 200
Waterford, MI 48327-1970
Phone (248) 625-9099

6507 Town Ctr Dr
Suite a
Clarkston, MI 48346-4826
Phone (248) 922-9975

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting37
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101014995MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meahealth PLC CurrentSince Apr 1, 2013 Accepting new patients
McLaren Oakland Cardiovascular Disease Current Accepting new patients
McLaren Medical Group CurrentSince Mar 1, 2023 Accepting new patients
McLaren Oakland CurrentSince Aug 21, 2017 Accepting new patients
McLaren Medical Group Interventional Cardiology CurrentSince Mar 1, 2023 Accepting new patients
McLaren Macomb Cardiovascular Disease CurrentSince Oct 27, 2013 Accepting new patients
McLaren Oakland CurrentSince Aug 21, 2017 Accepting new patients
McLaren Macomb Past Accepting new patients
McLaren Medical Group Past Accepting new patients

Locations

8172 Reliable Pkwy
Chicago, IL 60686
Phone (517) 908-0847

32901 23 Mile Rd
Ste 120
Chesterfield, MI 48047
Phone (586) 725-4604

6507 Town Center Dr
Ste A
Clarkston, MI 48346
Phone (248) 922-9975

37399 Garfield Rd
Ste 203
Clinton Twp, MI 48036
Phone (586) 228-2911

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

66440 Gratiot Ave
Ste 103
Lenox, MI 48050
Phone (586) 430-4022

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

1030 Harrington St
Ste 101
Mount Clemens, MI 48043
Phone (586) 464-4010

1030 Harrington St
Ste 206
Mount Clemens, MI 48043
Phone (586) 493-3260

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

3250 W Big Beaver Rd
Ste 144
Troy, MI 48084
Phone (248) 637-7100

5210 Highland Rd
Ste 200
Waterford, MI 48327
Phone (248) 625-9099

Interoperability endpoints

  • Direct secure messaging: mdeyoung21794@direct.trinity-health.org
  • Direct secure messaging: mdeyoung63449@direct.hfhs.org

Organizations & group practices 9

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 8

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487861043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 MORAN RD",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363212",
            "telephone_number": "313-885-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON BLVD.",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYOUNG",
        "first_name": "MICHAEL",
        "middle_name": "BLAIR",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5101014995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.