Jerrold Fisher, MD

Individual provider Active NPI Emergency Medicine Physician · Fraser, MI

NPI 1700824968 · NPPES record last updated Nov 7, 2008

Key facts

NPI
1700824968
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Medicine Physician 207P00000X
License
4301056717 (MI)
Practice address
17717 Masonic
Fraser, MI 48026-3158
Phone
(586) 294-0600
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

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 2

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

Medicare Care Compare profile

Specialty
Emergency Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Observation Physicians PLLC (138 clinicians)
Independent Emergency Physicians PC (173 clinicians)

Practice addresses (Care Compare)

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

Hospital & facility affiliations

  • Henry Ford Health St John Hospital Hospital · Detroit, MI · CCN 230165
  • Ascension Providence Hospital, Southfield and Novi Hospital · Southfield, MI · CCN 230019

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040526001142 MI Practitioner - Emergency Medicine 0547241416 Reassigns benefits to 4 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Observation Physicians PLLC Current
since Aug 1, 2024
Accepting new patients
Independent Emergency Physicians, P.C. Current
since Sep 1, 2024
Accepting new patients
Observation Emergency Physicians, P.C. Emergency Medicine Current
since Aug 1, 2008
Accepting new patients
Emergency Department Physicians, P.C. Emergency Medicine Current
since Jan 1, 2004
Accepting new patients

Locations

36750 26 Mile Rd
Chesterfield, MI 48047
Phone (586) 879-2000

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

4100 S River Rd
East China, MI 48054
Phone (810) 329-6677

17717 Masonic
Fraser, MI 48026
Phone (586) 294-0600

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

17700 23 Mile Rd
Macomb, MI 48044
Phone (586) 416-7500

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: jfisher1126809@direct.hfhs.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301056717 MI Yes

Addresses

Primary practice location

17717 Masonic
Fraser, MI 48026-3158

Mailing address

17717 Masonic
Fraser, MI 48026-3158
Phone (586) 294-0600

Other providers in Fraser, MI

All providers in Fraser, MI · Emergency Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.