Individual provider Active NPI

Ethan Graham Englert, MD

  • Pediatric Orthopaedic Surgery Physician
  • Royal Oak, MI
National Provider Identifier
1548634330
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
14213758-1205 Issued in UT
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073
Phone
(248) 551-3140
Fax
(248) 551-5404
NPI assigned
Nov 17, 2015
Last updated
Mar 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4351045178 MI
Pediatric Orthopaedic Surgery Physician 207XP3100X 14213758-1205 UT Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

3535 W 13 Mile Rd Ste 742
Royal Oak, MI 48073-6770
Phone (248) 551-9100

Other practice location 2

10000 Telegraph Rd Ste 100
Taylor, MI 48180-3330
Phone (313) 889-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address genglert800388@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20250916004699 UT Practitioner - Orthopedic Surgery 9739412438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Northwestern University Feinberg Medical School, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 299
Salt Lake City, UT 84110

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
66.73
Promoting interoperability
100
Improvement activities
40
Cost
70.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14213758-1205UTMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Pediatric Services CurrentSince Aug 1, 2025 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
University of Utah Adult Services CurrentSince Aug 1, 2025 Accepting new patients
University of Utah Pediatric Services Pediatric Orthopaedic Surgery CurrentSince Aug 1, 2025 Accepting new patients
University of Utah Adult Services CurrentSince Aug 1, 2025 Accepting new patients
University of Utah Pediatric Services Past Accepting new patients
Shriners Hospitals for Children Pediatric Orthopaedic Surgery Past Accepting new patients

Locations

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: genglert800388@direct.med.utah.edu

Organizations & group practices 8

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": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1548634330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "48073",
            "telephone_number": "248-551-3140",
            "fax_number": "248-551-5404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 W 13 Mile Rd Ste 742",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736770",
            "country_code": "US",
            "telephone_number": "248-551-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10000 Telegraph Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Taylor",
            "state": "MI",
            "postal_code": "481803330",
            "country_code": "US",
            "telephone_number": "313-889-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENGLERT",
        "first_name": "ETHAN",
        "middle_name": "GRAHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-17",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4351045178",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "UT",
            "license": "14213758-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "genglert800388@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.