NPIMap

Individual provider Active NPI

David Komasara, D.O.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
National Provider Identifier
1861433302
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
5101011074 Issued in MI
Practice address
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone
(248) 849-3000
NPI assigned
Jun 8, 2006
Last updated
Nov 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 5101011074 MI Primary

Addresses

Primary practice location

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Mailing address

28868 Salem Rd
Farmington Hills, MI 48334-3138

Other identifiers 5

IdentifierTypeStateIssuer
114287137MedicaidMI
DK011074OtherMIBC/BS OF MICHIGAN
114713696MedicaidMI
113377937MedicaidMI
114274961MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050307000403 MI Practitioner - Emergency Medicine 3072425610 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Emergency Care PCGroup PAC ID 3870493588, 21 clinicians

Practice addresses (Care Compare)

130 Millwood St
Caro, MI 48723-1630
Phone (989) 672-1555

274 E Chicago St
Coldwater, MI 49036-2041
Phone (517) 279-5400

4675 Hill St
Cass City, MI 48726-1008
Phone (989) 912-6275

650 W Sanilac Rd
Sandusky Rapid Care
Sandusky, MI 48471-9704
Phone (989) 912-6790

684 N Port Crescent St
Bad Axe, MI 48413-1275
Phone (989) 912-6036

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101011074MIMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deckerville Community Hospital, Inc CurrentSince May 1, 2024 Accepting new patients
Hills & Dales General Hospital, Inc. Current Accepting new patients
Deckerville Community Hospital, Inc. CurrentSince May 1, 2024 Accepting new patients
Degara App, PLLC CurrentSince Jan 23, 2017 Accepting new patients
Hills & Dales General Hospital, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Hills & Dales General Hospital, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Professional Emergency Care, PC CurrentSince Jul 1, 2025 Accepting new patients
Marlette Regional Hospital Current Accepting new patients
Beacon Kalamazoo Inc CurrentSince Mar 1, 2016 Accepting new patients
Beacon Kalamazoo Inc Current Accepting new patients
Sound Physicians Emergency Medicine of Michigan, PLLC CurrentSince Dec 21, 2016 Accepting new patients
Marlette Regional Hospital CurrentSince Oct 20, 2024 Accepting new patients
Ascension Borgess Hospital CurrentSince Mar 1, 2016 Accepting new patients
Marlette Regional Hospital CurrentSince Oct 20, 2024 Accepting new patients
Hills & Dales General Hospital, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Marlette Regional Hospital Past Accepting new patients
Independent Observation Physicians PLLC Emergency Medical Services PastSince May 11, 2025 Accepting new patients
Independent Emergency Physicians, P.C. Emergency Medical Services PastSince Oct 12, 2025 Accepting new patients

Locations

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

4675 Hill St
Cass City, MI 48726
Phone (989) 872-2121

4675 Hill St
Ste B
Cass City, MI 48726
Phone (989) 912-6112

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

274 E Chicago St
Coldwater, MI 49036
Phone (517) 279-5400

3559 Pine St
Deckerville, MI 48427
Phone (810) 376-2835

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

2770 Main St
Marlette, MI 48453
Phone (989) 635-4000

2771 Angle St
Marlette, MI 48453
Phone (989) 635-4000

2985 Main St
Marlette, MI 48453
Phone (989) 635-2031

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

650 W Sanilac Rd
Sandusky, MI 48471
Phone (989) 912-6725

701 S Health Parkway
Three Rivers, MI 49093
Phone (269) 273-9691

Interoperability endpoints

  • Direct secure messaging: dkomasara58083@direct.covenanthealthcare.com

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 12

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1861433302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28868 SALEM RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMASARA",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "5101011074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114287137",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MICHIGAN",
            "identifier": "DK011074",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114713696",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113377937",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114274961",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.