Individual provider Active NPI

Emma E Cermak, MD

  • Obstetrics & Gynecology Physician
  • Detroit, MI
National Provider Identifier
1609190255
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301508556 Issued in MI
Practice address
400 Mack Ave
Detroit, MI 48201-2136
Phone
(313) 448-9650
NPI assigned
Mar 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2018019493 MO
Obstetrics & Gynecology Physician 207V00000X 4301508556 MI Primary

Addresses

Primary practice location

400 Mack Ave
Detroit, MI 48201-2136

Mailing address

400 Mack Ave
Detroit, MI 48201-2136
Phone (313) 448-9006

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
I20230522000821 MI Practitioner - Obstetrics/Gynecology 3870806110 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Obstetrics & Gynecology CurrentSince May 9, 2023 Accepting new patients
University Physician Group Past Accepting new patients
University Physician Group Past Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients

Locations

3990 John R St
Ste 4240
Detroit, MI 48201
Phone (248) 556-6428

400 Mack Ave
Detroit, MI 48201
Phone (313) 448-9006

400 Mack Ave
Ste 2
Detroit, MI 48201
Phone (313) 448-9006

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

26400 W 12 Mile Rd
Ste 111
Southfield, MI 48034
Phone (248) 357-4151

26400 W 12 Mile Rd
Ste 145
Southfield, MI 48034
Phone (248) 359-8034

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

Interoperability endpoints

  • Direct secure messaging: emma.cermak.1@19711.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician Group 399 clinicians

Practice addresses (Care Compare)

400 Mack Ave 2
Detroit Mack Health Center
Detroit, MI 48201-2136
Phone (313) 448-9006

Hospital & facility affiliations

  • Harper University Hospital Hospital, Detroit, MI, CCN 230104

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1609190255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136",
            "telephone_number": "313-448-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136",
            "telephone_number": "313-448-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERMAK",
        "first_name": "EMMA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2018019493",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301508556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.