Individual provider Active NPI

Robert Daniel Travis, MD

  • Orthopaedic Surgery Physician
  • Canton, MI
National Provider Identifier
1629036389
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301064261 Issued in MI
Practice address
44633 Joy Rd
Suite 200
Canton, MI 48187-1730
Phone
(734) 451-9692
Fax
(734) 451-9606
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4301064261 MI Primary

Addresses

Primary practice location

44633 Joy Rd
Suite 200
Canton, MI 48187-1730

Mailing address

44633 Joy Rd
Suite 200
Canton, MI 48187-1730
Phone (734) 451-9692

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
I20040909000682 MI Practitioner - Orthopedic Surgery 0244206332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Georgetown University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Lapeer RegionGroup PAC ID 8123000544, 36 clinicians

Practice addresses (Care Compare)

1375 N Main St
Lapeer, MI 48446-1350
Phone (810) 667-5677

33155 Annapolis St
Wayne, MI 48184-2405
Phone (734) 467-4000

44633 Joy Rd
Suite 200
Canton, MI 48187-1732
Phone (734) 451-9692

809 W Dryden Rd
McLaren Community Medical Center Metamora
Metamora, MI 48445-8961
Phone (810) 678-4000

Hospital & facility affiliations

  • McLaren Lapeer Region Hospital, Lapeer, MI, CCN 230193
  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
  • Lake Huron Medical Center Hospital, Port Huron, MI, CCN 230031
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302
  • McLaren Flint Hospital, Flint, MI, CCN 230141

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301064261MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Lapeer Region CurrentSince Jun 23, 2014 Accepting new patients
McLaren Lapeer Region Current Accepting new patients
McLaren Lapeer Region CurrentSince Jun 23, 2014 Accepting new patients
Orthopaedic Institute of Ohio, Inc. Orthopaedic Surgery Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
McLaren Lapeer Region Past Accepting new patients

Locations

1254 N Main St
Lapeer, MI 48446
Phone (810) 664-4531

1200 Barry Dr
Lapeer, MI 48446
Phone (810) 664-4532

809 W Dryden Rd
Metamora, MI 48455
Phone (810) 678-4000

Interoperability endpoints

  • Direct secure messaging: rtravis250073@direct.hfhs.org

Organizations & group practices 7

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 5

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1629036389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44633 JOY RD",
            "address_2": "SUITE 200",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871730",
            "telephone_number": "734-451-9692",
            "fax_number": "734-451-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44633 JOY RD",
            "address_2": "SUITE 200",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871730",
            "telephone_number": "734-451-9692",
            "fax_number": "734-451-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVIS",
        "first_name": "ROBERT",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301064261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.