Individual provider Active NPI

Edward W Schervish, MD

  • Urology Physician
  • St Clair Shores, MI
National Provider Identifier
1861457772
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
4301405285 Issued in MI
Practice address
20952 E 12 Mile Rd
Suite 200
St Clair Shores, MI 48081-3200
Phone
(586) 771-4820
Fax
(586) 771-6620
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4301405285 MI Primary

Addresses

Primary practice location

20952 E 12 Mile Rd
Suite 200
St Clair Shores, MI 48081-3200

Mailing address

20952 E 12 Mile Rd
Suite 200
St Clair Shores, MI 48081-3200
Phone (586) 771-4820

Other identifiers 6

IdentifierTypeStateIssuer
F02013OtherMIHAP
01004491OtherMIHEALTH PLUS
103356OtherMIPRIORITY HEALTH
340006535OtherMIRAILROAD MEDICARE
5135046OtherMIAETNA
2366014003OtherMICIGNA

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
I20050217000846 MI Practitioner - Urology 3779495130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.86 of 100Reported as group
Quality
81.01
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physician Services of Michigan, P.C. Urology CurrentSince Mar 1, 1982 Accepting new patients
Michigan Institute of Urology PC Urology CurrentSince Mar 1, 1982 Accepting new patients

Locations

20952 E 12 Mile Rd
Ste 200
St Clr Shores, MI 48081
Phone (586) 771-4820

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1861457772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHERVISH",
        "first_name": "EDWARD",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301405285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "F02013",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "01004491",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "103356",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340006535",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5135046",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2366014003",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.