Individual provider Active NPI

Allison A Stoecker, D.O.

  • MOHS-Micrographic Surgery Physician
  • Ann Arbor, MI
National Provider Identifier
1720436397
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
5101026056 Issued in MI
Practice address
2433 Oak Valley Dr Ste 400
Ann Arbor, MI 48103-7602
Phone
(734) 477-0200
NPI assigned
May 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X DO184772 OR
MOHS-Micrographic Surgery Physician 207ND0101X DO184772 OR
MOHS-Micrographic Surgery Physician 207ND0101X 5101026056 MI Primary

Addresses

Primary practice location

2433 Oak Valley Dr Ste 400
Ann Arbor, MI 48103-7602

Mailing address

5141 Virginia Way Ste 350
Brentwood, TN 37027-2319
Phone (855) 744-8554

Other practice location 1

123 Lansing St
Charlotte, MI 48813-1696
Phone (866) 915-9152

Other practice location 2

6888 Grand River Rd
Brighton, MI 48114-9345
Phone (810) 220-4422

Other practice location 3

2685 Jolly Rd
Okemos, MI 48864-3553
Phone (734) 594-7931

Other practice location 4

8245 Holly Rd Ste 101
Grand Blanc, MI 48439-2443
Phone (810) 606-7500

Other practice location 5

37605 Pembroke Ave
Livonia, MI 48152-1050
Phone (734) 591-7931

Other practice location 6

5084 Villa Linde Pkwy Ste 5
Flint, MI 48532-3422
Phone (810) 733-6050

Other practice location 7

401 E Elm St
Carson City, MI 48811-8600
Phone (866) 915-9152

Other practice location 8

5131 W Bristol Rd Ste A
Flint, MI 48507-2970
Phone (810) 733-2090

Other practice location 9

2256 W Hill Rd
Flint, MI 48507-4655
Phone (810) 249-7546

Other identifiers 3

IdentifierTypeStateIssuer
5101026056OtherMISTATE LICENSE
5315223017OtherMICDS
1720436397MedicaidMI

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
I20210330000785 MI Practitioner - Dermatology 5799070207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Michigan State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

2256 W Hill Rd
Flint, MI 48507-4655
Phone (810) 249-7546

Merit-based Incentive Payment System (MIPS)

Final score
89.8 of 100Reported as group
Promoting interoperability
88
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision241
Removal of skin lesions71
Removal of skin cancer998
Skin biopsy20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO184772ORMDDermatology Physician
5101026056MIMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Audrey Bruell, M.D. P.C. Dermatology Current Accepting new patients
Robert M Soderstrom MD PC Dermatology PastSince Mar 1, 2021 Accepting new patients

Locations

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

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1720436397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5141 VIRGINIA WAY STE 350",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370272319",
            "telephone_number": "855-744-8554",
            "fax_number": "630-495-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2433 OAK VALLEY DR STE 400",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481037602",
            "telephone_number": "734-477-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Lansing St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "MI",
            "postal_code": "488131696",
            "country_code": "US",
            "telephone_number": "866-915-9152",
            "fax_number": "517-332-1696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6888 Grand River Rd",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481149345",
            "country_code": "US",
            "telephone_number": "810-220-4422",
            "fax_number": "810-220-1123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2685 Jolly Rd",
            "address_purpose": "LOCATION",
            "city": "Okemos",
            "state": "MI",
            "postal_code": "488643553",
            "country_code": "US",
            "telephone_number": "734-594-7931",
            "fax_number": "734-464-0335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8245 Holly Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Grand Blanc",
            "state": "MI",
            "postal_code": "484392443",
            "country_code": "US",
            "telephone_number": "810-606-7500",
            "fax_number": "810-606-9600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37605 Pembroke Ave",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481521050",
            "country_code": "US",
            "telephone_number": "734-591-7931",
            "fax_number": "734-464-0335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5084 Villa Linde Pkwy Ste 5",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485323422",
            "country_code": "US",
            "telephone_number": "810-733-6050",
            "fax_number": "810-733-5991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 E Elm St",
            "address_purpose": "LOCATION",
            "city": "Carson City",
            "state": "MI",
            "postal_code": "488118600",
            "country_code": "US",
            "telephone_number": "866-915-9152",
            "fax_number": "517-332-1696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5131 W Bristol Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485072970",
            "country_code": "US",
            "telephone_number": "810-733-2090",
            "fax_number": "630-495-1770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2256 W Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485074655",
            "country_code": "US",
            "telephone_number": "810-249-7546",
            "fax_number": "734-464-0335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOECKER",
        "first_name": "ALLISON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "DO184772",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "OR",
            "license": "DO184772",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MI",
            "license": "5101026056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5101026056",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "5315223017",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720436397",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.