Individual provider Active NPI

John Thomas Fortunato, MD

  • Neurology Physician
  • Ann Arbor, MI
National Provider Identifier
1841783115
Registry record updated Aug 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4301511173 Issued in MI
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

Updated by the provider on Aug 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829002520 MI Practitioner - Neurology 1153663737 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
4301511173MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Aug 13, 2024 Accepting new patients
Regents of the University of Michigan Neurology CurrentSince Aug 13, 2024 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.