Active NPI
Logan Burtenshaw, DO
- Dermatology Physician
- Dearborn, MI
National Provider Identifier
1801733506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 5151018096
- Practice address
- 18101 Oakwood Blvd
Dearborn, MI 48124-4089 - Phone
- (313) 593-7000
- NPI assigned
- Apr 30, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 5151018096 | MI | Primary |
Addresses
Primary practice location
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Mailing address
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 593-7000
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260507003148 | MI | Order and Referring Only - Dermatology | 3779051750 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5151018096 | MI | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777507200000",
"number": "1801733506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18101 OAKWOOD BLVD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481244089",
"telephone_number": "313-593-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18101 OAKWOOD BLVD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481244089",
"telephone_number": "313-593-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURTENSHAW",
"first_name": "LOGAN",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-04-30",
"last_updated": "2026-04-30",
"certification_date": "2026-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MI",
"license": "5151018096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.