Active NPI
John E Blanzy, DO
- Family Medicine Physician
- Southgate, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101004825
- Practice address
- 14319 Dix-Toledo Rd
Southgate, MI 48195 - Phone
- (734) 285-0677
- Fax
- (734) 285-3574
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101004825 | MI | Primary |
Addresses
Primary practice location
14319 Dix-Toledo Rd
Southgate, MI 48195
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1863
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111182991 | Medicaid | MI | |
| 5820194 | Other | MI | BCBSM |
| 107352 | Other | CARE CHOICES | |
| DR820558 | Other | M-CARE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jblanzy110597@direct.beaumont.edu |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1960
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14319 Dix Toledo Rd
Southgate, MI 48195-2506
Phone (734) 285-0677
201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065
Hospital & facility affiliations
- Beaumont Hospital - Dearborn
- Beaumont Hospital Royal Oak
- Beaumont Hospital - Taylor
- Corewell Health Trenton Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101004825 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakwood Ambulatory, LLC | Current | Accepting new patients | |
| Oakwood Ambulatory LLC | Family Medicine | Current | Accepting new patients |
Locations
201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065
26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860
14319 Dix Toledo Rd
Southgate, MI 48195
Phone (734) 285-0677
Interoperability endpoints
- jblanzy110597@direct.beaumont.edu
Organizations & group practices 2
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.
-
- Podiatrist
- Westland, MI
- NPI 1013157361
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Taylor, MI
- NPI 1487605168
-
- General Acute Care Hospital
- Dearborn, MI
- NPI 1740230119
-
- General Acute Care Hospital
- Trenton, MI
- NPI 1740230648
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
-
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1629017207",
"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",
"telephone_number": "947-522-1863",
"fax_number": "947-522-0307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14319 DIX-TOLEDO RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "48195",
"telephone_number": "734-285-0677",
"fax_number": "734-285-3574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANZY",
"first_name": "JOHN",
"middle_name": "E",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101004825",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111182991",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "5820194",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE CHOICES",
"identifier": "107352",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "M-CARE",
"identifier": "DR820558",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jblanzy110597@direct.beaumont.edu",
"affiliation": "N",
"address_1": "14319 Dix-Toledo Rd",
"city": "Southgate",
"state": "MI",
"country_code": "US",
"postal_code": "48195",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.