Individual provider Active NPI

Emily Lynn Cetner, D.O.

  • Pediatrics Physician
  • West Bloomfield, MI
National Provider Identifier
1871759357
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101020824 Issued in MI
Practice address
5793 W Maple Rd Ste 153
West Bloomfield, MI 48322-4478
Phone
(248) 539-7726
Fax
(248) 539-7823
NPI assigned
Aug 4, 2008
Last updated
Feb 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036125387 IL
Pediatrics Physician 208000000X 5101020824 MI Primary

Addresses

Primary practice location

5793 W Maple Rd Ste 153
West Bloomfield, MI 48322-4478

Mailing address

5793 W Maple Rd Ste 153
West Bloomfield, MI 48322-4478
Phone (248) 539-7726

Other names 1

  • Emily Lynn Wolfson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036125387ILMDPediatrics Physician
5101020824MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lurie Childrens Primary Care LLC Pediatrics Past Accepting new patients
Town and Country Pediatrics Pediatrics Past Accepting new patients
Medical Center Pediatrics PLLC Pediatrics PastSince Feb 27, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ecetner@medcenterpeds.opdirect.net
  • Direct secure messaging: ecetner1041284@direct.hfhs.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1871759357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5793 W MAPLE RD STE 153",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224478",
            "telephone_number": "248-539-7726",
            "fax_number": "248-539-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5793 W MAPLE RD STE 153",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224478",
            "telephone_number": "248-539-7726",
            "fax_number": "248-539-7823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CETNER",
        "first_name": "EMILY",
        "middle_name": "LYNN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036125387",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101020824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "WOLFSON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.