Individual provider Active NPI

Debra Mary Van Ort, D.O.

  • Family Medicine Physician
  • Commerce Township, MI
National Provider Identifier
1770634305
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DV009592 Issued in MI
Practice address
8391 Commerce Rd Ste 103
Commerce Township, MI 48382-4489
Phone
(248) 690-6966
Fax
(248) 535-0226
NPI assigned
Jan 12, 2007
Last updated
Sep 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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 DV009592 MI Primary

Addresses

Primary practice location

8391 Commerce Rd Ste 103
Commerce Township, MI 48382-4489

Mailing address

8391 Commerce Rd Ste 103
Commerce Township, MI 48382-4489
Phone (248) 690-6966

Other identifiers 2

IdentifierTypeStateIssuer
0156308105OtherMIBCBS
MI12421OtherMIMEDICARE

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
I20080620000427 MI Practitioner - Family Practice 1355412172 Reassigns benefits to 1 organization
Practice locations: Commerce Township, MI

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Family Health Care PCGroup PAC ID 9638077621, 20 clinicians

Practice addresses (Care Compare)

29600 S Wixom Rd
Wixom, MI 48393-3459
Phone (248) 668-1900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DV009592MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Family Health Care, P.C. Family Medicine CurrentSince Nov 26, 2022 Accepting new patients
Debra Vanort, DO Family Medicine CurrentSince Jan 1, 2019 Accepting new patients
BC Podiatry PLLC Past Accepting new patients
Pure Internal Medicine PLLC PastSince Sep 6, 2017 Accepting new patients

Locations

8391 Commerce Rd
Ste 110A
Commerce Twp, MI 48382
Phone (248) 321-8864

2255 Fort St
Lincoln Park, MI 48146
Phone (313) 357-7500

28212 Franklin Rd
Southfield, MI 48034

29600 S Wixom Rd
Wixom, MI 48393
Phone (248) 668-1900

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

Interoperability endpoints

  • Direct secure messaging: dvanort367463@direct.hfhs.org
  • FHIR API: https://api.platform.athenahealth.com/19192/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1770634305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8391 COMMERCE RD STE 103",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483824489",
            "telephone_number": "248-690-6966",
            "fax_number": "248-653-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8391 COMMERCE RD STE 103",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483824489",
            "telephone_number": "248-690-6966",
            "fax_number": "248-535-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ORT",
        "first_name": "DEBRA",
        "middle_name": "MARY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "DV009592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0156308105",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MI12421",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce Township, MI

Sources for this page

Verify at the official NPI Registry.