NPIMap

Individual provider Active NPI

Nathan Allen Quaderer, DO

  • Family Medicine Physician
  • Grand Blanc, MI
National Provider Identifier
1760971451
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101023787 Issued in MI
Practice address
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone
(810) 606-5985
NPI assigned
May 8, 2018
Last updated
May 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101023787 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Mailing address

1460 N Center Rd
Burton, MI 48509-1429
Phone (810) 715-4300

Other practice location 1

1460 N Center Rd
Burton, MI 48509-1429
Phone (810) 715-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210809002513 MI Practitioner - Family Practice 5698029288 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians

Practice addresses (Care Compare)

10785 S Saginaw St
Suite D
Grand Blanc, MI 48439-7003
Phone (810) 695-6337

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101023787MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Medical Group Genesys Family Medicine CurrentSince Dec 27, 2025 Accepting new patients
Henry Ford Medical Group Genesys CurrentSince Dec 27, 2025 Accepting new patients
Genesys Pho LLC CurrentSince Sep 1, 2021 Accepting new patients
Indira Alluru MD PC Current Accepting new patients
Fenton Family Medicine, P.C. Family Medicine CurrentSince Sep 1, 2021 Accepting new patients

Locations

445 N Fenway Dr
Fenton, MI 48430
Phone (810) 616-7246

3495 S Center Rd
Flint, MI 48519
Phone (810) 424-2025

10785 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 695-6337

Interoperability endpoints

  • Direct secure messaging: nathanquaderer@pmi.allscriptsdirect.net
  • Direct secure messaging: nquaderer1145248@direct.hfhs.org

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1760971451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 N CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091429",
            "telephone_number": "810-715-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1460 N Center Rd",
            "address_purpose": "LOCATION",
            "city": "Burton",
            "state": "MI",
            "postal_code": "485091429",
            "country_code": "US",
            "telephone_number": "810-715-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUADERER",
        "first_name": "NATHAN",
        "middle_name": "ALLEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101023787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.