Individual provider Active NPI

Anthony Joseph Agrusa, D.O.

  • Family Medicine Physician
  • Clarkston, MI
National Provider Identifier
1528419199
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101022413 Issued in MI
Practice address
5701 Bow Pointe Dr Ste 100
Clarkston, MI 48346
Phone
(248) 625-2621
Fax
(248) 625-2622
NPI assigned
Jun 24, 2016
Last updated
Oct 30, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101022413 MI Primary

Addresses

Primary practice location

5701 Bow Pointe Dr Ste 100
Clarkston, MI 48346

Mailing address

5701 Bow Pointe Dr Ste 100
Clarkston, MI 48346-3199
Phone (248) 625-2621

Other practice location 1

1200 E Michigan Ave
Lansing, MI 48912-1800
Phone (517) 364-5772

Other identifiers 1

IdentifierTypeStateIssuer
5101022413OtherMIMEDICAL LICENSE NUMBER

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
I20190822000508 MI Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 4587992011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Michigan State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5701 Bow Pointe Dr
Suite 100
Clarkston, MI 48346-3199
Phone (248) 625-2621

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
McLaren Community Based Primary Care Group Family Medicine CurrentSince Dec 31, 2025 Accepting new patients
McLaren Community Based Primary Care Group CurrentSince Dec 31, 2025 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Jul 1, 2019 Accepting new patients

Locations

5625 Water Tower Pl
Ste 200
Clarkston, MI 48346
Phone (248) 625-2621

5625 Water Tower Pl
Ste 300
Clarkston, MI 48346
Phone (248) 625-2621

5701 Bow Pointe Dr
Ste 100
Clarkston, MI 48346
Phone (248) 625-2621

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

834 S Lapeer Rd
Ste 100
Oxford, MI 48371
Phone (248) 384-8320

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

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.

Hospital & facility affiliations 4

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": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1528419199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR STE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463199",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR STE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121800",
            "country_code": "US",
            "telephone_number": "517-364-5772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGRUSA",
        "first_name": "ANTHONY",
        "middle_name": "JOSEPH",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-24",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101022413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "5101022413",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.