Roger B Fenton, DO

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

5101006368 Issued in MI

Practice address

27379 Dequindre
Madison Heights, MI 48071

Phone

(248) 398-4488

Fax

(248) 398-4995

NPI assigned

Aug 14, 2006

Last updated

Jun 14, 2011By the provider in NPPES

Sex

Male

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 2

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

Diagnostic Radiology

Education

Michigan State University College of Osteopathic Medicine, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Orthopaedic Surgeons PLLCGroup PAC ID 7810277811, 127 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: roger.fenton.1@9974.direct.athenahealth.com

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.

• Michigan Orthopaedic Surgeons, PLLC

  • Orthopaedic Surgery Physician
  • Southfield, MI
  • NPI 1306394309
  Medicare reassignment Care Compare group NPD
• Advanced MRI Imaging, PLLC

  • Diagnostic Radiology Physician
  • Southfield, MI
  • NPI 1295996080
  Authorized official Same address or phone

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1780697425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4996 CHAMPLAIN CIRCLE",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "48323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27379 DEQUINDRE",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "48071",
            "telephone_number": "248-398-4488",
            "fax_number": "248-398-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "ROGER",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101006368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "200F311140",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2768532",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Wagman Federman, D.O.
• Myron Fedoriw
• Erwin E Feldman, D.O.
• Randy S Feldman, DPM
• Myesha Fennick, LPN
• Nicolette Diane Fey, PT, DPT
• Taylor Finch
• Amber Nusbaum Finney, PHARMD
• Michael Fiorillo, LMSW
• First Choice Home Care Health Care Services,Inc

• Diagnostic Radiology Physician in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.