Active NPI
John Thomas Fortunato, MD
- Neurology Physician
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 4301511173
- Practice address
- 1500 E Medical Center Dr
Ann Arbor, MI 48109-5000 - Phone
- (734) 936-4000
- NPI assigned
- Jun 12, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 125.073499 | IL | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neurology Physician | 2084N0400X | 4301511173 | MI | Primary |
Addresses
Primary practice location
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Mailing address
3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299
Other practice location 1
5841 S Maryland Ave # Mc2030
Chicago, IL 60637
Phone (773) 702-0151
Other practice location 2
Henry Ford Hospital Medical Education Department
2799 W. Grand Boulevard
Detroit, MI 48202-2608
Phone (313) 916-2889
Other practice location 3
Henry Ford Hospital Medical Education Department
2799 W. Grand Boulevard
Detroit, MI 48202-2608
Phone (313) 916-2889
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
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Oakland Univ, William Beaumont School of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
7500 Challis Rd
Brighton, MI 48116-9416
Phone (810) 263-4000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301511173 | MI | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of Michigan | Current | Accepting new patients | |
| Regents of the University of Michigan | Neurology | Current | Accepting new patients |
| Regents of the University of Michigan | Current | Accepting new patients | |
| Regents of the University of Michigan | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280
3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229
8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510
7500 Challis Rd
Brighton, MI 48116
Phone (734) 764-4190
Organizations & group practices 5
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.
-
- Internal Medicine Physician
- Ann Arbor, MI
- NPI 1205868353
-
- Neurology Physician
- Ann Arbor, MI
- NPI 1053343004
-
- Specialty Pharmacy
- Dexter, MI
- NPI 1952181919
-
dba University of Michigan Health System
- General Acute Care Hospital
- Ann Arbor, MI
- NPI 1003878539
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba University of Michigan Health System
- General Acute Care Hospital
- Ann Arbor, MI
- NPI 1003878539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723939200000",
"number": "1841783115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481081633",
"telephone_number": "734-647-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E MEDICAL CENTER DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481095000",
"telephone_number": "734-936-4000"
}
],
"practiceLocations": [
{
"address_1": "5841 S Maryland Ave # Mc2030",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "60637",
"country_code": "US",
"telephone_number": "773-702-0151",
"fax_number": "773-834-3662",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Henry Ford Hospital Medical Education Department",
"address_2": "2799 W. Grand Boulevard",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482022608",
"country_code": "US",
"telephone_number": "313-916-2889",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Henry Ford Hospital Medical Education Department",
"address_2": "2799 W. Grand Boulevard",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482022608",
"country_code": "US",
"telephone_number": "313-916-2889",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FORTUNATO",
"first_name": "JOHN",
"middle_name": "THOMAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-12",
"last_updated": "2024-08-18",
"certification_date": "2024-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "125.073499",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MI",
"license": "4301511173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2024; 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.