Individual provider Active NPI

Benjamin Bolcer, DO

  • Family Medicine Physician
  • Sterling Heights, MI
National Provider Identifier
1861182479
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5151016207 Issued in MI
Practice address
44250 Dequindre Rd
Sterling Heights, MI 48314-1002
Phone
(248) 964-0400
NPI assigned
May 9, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 5151016207 MI Primary

Addresses

Primary practice location

44250 Dequindre Rd
Sterling Heights, MI 48314-1002

Mailing address

44250 Dequindre Rd
Sterling Heights, MI 48314-1002
Phone (248) 964-0400

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
I20230627002871 MI Order and Referring Only - Family PracticePractitioner - Family Practice 4688032394

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5151016207MIMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: bolcer.benjamin.1@14250.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1861182479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44250 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141002",
            "telephone_number": "248-964-0400",
            "fax_number": "248-964-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44250 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141002",
            "telephone_number": "248-964-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLCER",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151016207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.