Individual provider Active NPI

Steven J Fischer, D.C., PA-C

  • Physician Assistant
  • Okemos, MI
National Provider Identifier
1649288549
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA20607 Issued in CA
Practice address
2685 Jolly Rd
Okemos, MI 48864-3553
Phone
(734) 594-7931
Fax
(734) 464-0335
NPI assigned
Aug 4, 2006
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA20607 CA Primary
Chiropractor 111N00000X 15922 CA

Addresses

Primary practice location

2685 Jolly Rd
Okemos, MI 48864-3553

Mailing address

5125 Skyway
Paradise, CA 95969-5624
Phone (530) 872-2000

Other practice location 1

38016 S Bonkay Dr
Clinton Township, MI 48036-2109
Phone (530) 872-2000

Other identifiers 1

IdentifierTypeStateIssuer
DC159220MedicaidCA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210601000701 MI Practitioner - Physician Assistant 4284886920 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20607CAMDSocial Worker
PA20607CAMDPhysician Assistant
15922CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Audrey Bruell, M.D. P.C. Current Accepting new patients
Craig M. Boyle, D.C., Inc. Chiropractor PastSince May 1, 2015 Accepting new patients
Bradley Mudge MD Inc Past Accepting new patients

Locations

37605 Pembroke Ave
Livonia, MI 48152
Phone (734) 591-7931

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, 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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1649288549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 SKYWAY",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959695624",
            "telephone_number": "530-872-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 JOLLY RD",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643553",
            "telephone_number": "734-594-7931",
            "fax_number": "734-464-0335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38016 S Bonkay Dr",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480362109",
            "country_code": "US",
            "telephone_number": "530-872-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C., PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20607",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "15922",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC159220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.