Audrey L Fan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301078173 Issued in MI

Practice address

39901 Traditions Dr
Northville, MI 48168-9493

Phone

(734) 998-2020

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Internal Medicine

Education

Vanderbilt University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Optimal Care Home Health Home health agency, Bingham Farms, MI, CCN 237504
• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: afan24741@direct.med.umich.edu

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.

• Regents of the University of Michigan

  • Internal Medicine Physician
  • Ann Arbor, MI
  • NPI 1205868353
  Medicare reassignment Care Compare group NPD
• Regents of the University of Michigan

  • Internal Medicine Physician
  • Ann Arbor, MI
  • NPI 1366472326
  NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD
• Regents of the University of Michigan

  dba University of Michigan Health System

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  NPD (past)

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

• Optimal Care, LLC

  dba Optimal Care Home Health

  • Home Health Agency
  • Bingham Farms, MI
  • NPI 1588697841
  Care Compare affiliation
• Regents of the University of Michigan

  dba University of Michigan Health System

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1750470977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39901 TRADITIONS DR",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481689493",
            "telephone_number": "734-998-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAN",
        "first_name": "AUDREY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301078173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4631723",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eye 2 Eye Contact
• Matina Fabian, LMSW
• Cecilia Margaret Fagan, PA
• Fairwood Dental PLLC (Jadestone Dental Studio)
• Family Medicine Obstetrics of Northville
• Lindsay Farrugia
• Charles Robert Feigel
• Jennifer Lynn Felicelli, M.S., LLP
• Quinn Felsner
• Cheyanne Ferris

• Internal Medicine Physician in Northville, MI
• Providers in Northville, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.

Verify at the official NPI Registry.