Christopher Dean Nedzlek, D.O.

Key facts

NPI: 1821264037
Entity type: Individual (NPI type 1)
Primary specialty: Emergency Medicine Physician 207P00000X
License: 5101017623 (MI)
Practice address: 2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone: (734) 246-7095
NPI assigned: May 7, 2008
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Epmg Downriver PLLC Emergency Medicine Physician · Wyandotte, MI · NPI 1093085441

Medicare reassignment Care Compare group NPD EMERGENCY MEDICINE · MI

Hospital & facility affiliations 2

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

Henry Ford Wyandotte Hospital Ambulatory Surgical Clinic/Center · Wyandotte, MI · NPI 1093901035

Care Compare affiliation Hospital
Henry Ford Wyandotte Hospital General Acute Care Hospital · Wyandotte, MI · NPI 1992725352

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Emergency Medicine
Education: Michigan State University College of Osteopathic Medicine, 2008
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Epmg Downriver PLLC (32 clinicians)

Practice addresses (Care Compare)

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (954) 939-5000

Hospital & facility affiliations

Wyandotte Hospital and Medical Center Hospital · Wyandotte, MI · CCN 230146

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20120628000610	MI	Practitioner - Emergency Medicine	9436314234	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy

Practice roles

Organization	Specialty	Status	New patients
Epmg Downriver PLLC	Emergency Medicine	Current since Jun 25, 2012	Accepting new patients

Locations

2000 Green Rd
Ste 300
Ann Arbor, MI 48105
Phone (313) 995-3764

23050 West Rd
Brownstown Twp, MI 48183
Phone (734) 287-9880

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

Interoperability endpoints

Direct secure messaging: cnedzlek221181@direct.hfhs.org

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Emergency Medicine Physician	207P00000X	5101017623	MI	Yes

Addresses

Primary practice location

2333 Biddle Ave
Wyandotte, MI 48192-4668

Mailing address

2000 Green Rd, Suite 300
Ann Arbor, MI 48105-1571
Phone (734) 246-7095

Electronic endpoints

Type	Endpoint	Use	Affiliation
Direct Messaging Address	cnedzlek221181@direct.hfhs.org		Henry Ford Wyandotte Hospital

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 1, 2022.

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1821264037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GREEN RD, SUITE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051571",
            "telephone_number": "734-246-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924668",
            "telephone_number": "734-246-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEDZLEK",
        "first_name": "CHRISTOPHER",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101017623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cnedzlek221181@direct.hfhs.org",
            "affiliation": "Y",
            "affiliationName": "Henry Ford Wyandotte Hospital",
            "address_1": "2333 Biddle Ave",
            "city": "Wyandotte",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481924668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wyandotte, MI

All providers in Wyandotte, MI · Emergency Medicine Physician in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.