Individual provider Active NPI

David Schrock, M.D.

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1548643331
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301108447 Issued in MI
Practice address
5635 W Fort St
Detroit, MI 48209-3154
Phone
(313) 849-3920
Fax
(313) 849-0824
NPI assigned
Jun 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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 4301108447 MI Primary

Addresses

Primary practice location

5635 W Fort St
Detroit, MI 48209-3154

Mailing address

5635 W Fort St
Detroit, MI 48209-3154
Phone (313) 849-3920

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
I20181030000052 MI Practitioner - Family Practice 5294035119 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians
Community Health and Social Services Center, IncGroup PAC ID 0547171514, shared by 3 NPIs, 6 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608

5635 W Fort St
Detroit, MI 48209-3154
Phone (313) 849-3920

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301108447MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henr Y Ford Health System Family Medicine CurrentSince Sep 15, 2018 Accepting new patients
Henry Ford Health System CurrentSince Sep 15, 2018 Accepting new patients
Community Health and Social Services Center, Inc Past Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

Interoperability endpoints

  • Direct secure messaging: dschrock264582@direct.hfhs.org

Organizations & group practices 6

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": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1548643331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 W FORT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482093154",
            "telephone_number": "313-849-3920",
            "fax_number": "313-849-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 W FORT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482093154",
            "telephone_number": "313-849-3920",
            "fax_number": "313-849-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROCK",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-30",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301108447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.