Frederick Michael Detorres, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

FD055364 Issued in MI

Practice address

6215 Harvey St
Muskegon, MI 49444-9739

Phone

(231) 799-8777

Fax

(231) 798-7423

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Allergy/ImmunologyAlso: Internal Medicine

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Shore Otolaryngology PCGroup PAC ID 4284998154, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• West Shore Otolaryngology PC

  dba West Shore ENT & Allergy Farr Rd

  • Multi-Specialty Clinic/Center
  • Norton Shores, MI
  • NPI 1548764426
  Medicare reassignment Care Compare group NPD
• Shoreline Allergy, P.C.

  • Allergy & Immunology Physician
  • Muskegon, MI
  • NPI 1568638732
  Medicare reassignment NPD
• West Shore Otolaryngology PC

  dba West Shore ENT & Allergy Grand Haven

  • Multi-Specialty Clinic/Center
  • Grand Haven, MI
  • NPI 1871097782
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health Partners

  dba Mercy Health Muskegon

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1518023480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 HARVEY ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494449739",
            "telephone_number": "231-799-8777",
            "fax_number": "231-798-7423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 HARVEY ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494449739",
            "telephone_number": "231-799-8777",
            "fax_number": "231-798-7423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETORRES",
        "first_name": "FREDERICK",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "FD055364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3478831",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "FD055634",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0618234",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dental Dreams PLLC
• Dental Impressions, PLC
• Laree C Depies, CRNA
• Hailey Depouw
• Dennis Vincent Desimone, DO
• Eric James Dettloff, PA-C
• Kirsten Avery Deuel
• Patricia J Deur, LMSW
• Brenda Deveau
• Nancy Claire Devine, M.D.

• Allergy & Immunology Physician in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Allergy & Immunology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.