Individual provider Active NPI

Deborah Oberdoerster, MD

  • Allergy & Immunology Physician
  • Ypsilanti, MI
National Provider Identifier
1508955444
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
4301049833 Issued in MI
Practice address
5333McAuley Dr
Suite R5011
Ypsilanti, MI 48197-1020
Phone
(734) 572-8834
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 4301049833 MI Primary
Internal Medicine Physician 207R00000X 4301049833 MI

Addresses

Primary practice location

5333McAuley Dr
Suite R5011
Ypsilanti, MI 48197-1020

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Other identifiers 1

IdentifierTypeStateIssuer
3122642MedicaidMI

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
I20100310000842 MI Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 5193860419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
University of Toledo College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 647-5940

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484
Phone (734) 647-5940

380 Parkland PLZ
Ann Arbor, MI 48103-6201
Phone (734) 647-5940

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301049833MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Allergy & Immunology CurrentSince Oct 1, 1999 Accepting new patients
Regents of the University of Michigan CurrentSince Oct 1, 1999 Accepting new patients
Regents of the University of Michigan Allergy & Immunology Past Accepting new patients

Locations

3621 S State St
#700
Ann Arbor, MI 48108

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

380 Parkland Plz
Ann Arbor, MI 48103
Phone (734) 615-3217

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

5333 McAuley Dr
Ste R5011
Ypsilanti, MI 48197
Phone (734) 572-8834

Interoperability endpoints

  • Direct secure messaging: doberdoerster25599@direct.med.umich.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1508955444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333MCAULEY DR",
            "address_2": "SUITE R5011",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971020",
            "telephone_number": "734-572-8834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERDOERSTER",
        "first_name": "DEBORAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "4301049833",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301049833",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3122642",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.