Active NPI
Joe Flynn, DO
- Emergency Medicine Physician
- Mount Clemens, MI
National Provider Identifier
1700945284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 5101009741
- Practice address
- 1000 Harrington St
Mount Clemens, MI 48043-2920 - Phone
- (586) 493-8000
- NPI assigned
- Dec 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 5101009741 | MI | Primary |
Addresses
Primary practice location
1000 Harrington St
Mount Clemens, MI 48043-2920
Mailing address
PO Box 8836
Grand Rapids, MI 49518-8836
Phone (866) 898-7139
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111984416 | Medicaid | MI | |
| 3355026475 | Other | BCBS |
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 CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 83.18 of 100
- Quality
- 69.61
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101009741 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Observation Physicians of Macomb PLLC | Emergency Medicine | Current | Accepting new patients |
Locations
1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727
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.
-
- Emergency Medicine Physician
- Mount Clemens, MI
- NPI 1144855941
-
- Emergency Medicine Physician
- Mount Clemens, MI
- NPI 1609235217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210896000000",
"number": "1700945284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8836",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495188836",
"telephone_number": "866-898-7139",
"fax_number": "616-975-9824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 HARRINGTON ST",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480432920",
"telephone_number": "586-493-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNN",
"first_name": "JOE",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-08",
"last_updated": "2008-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "5101009741",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111984416",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "3355026475",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mount Clemens, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.