Individual provider Active NPI

Daniel David Martin, M.D.

  • Otolaryngology Physician
  • Saint Clair Shores, MI
National Provider Identifier
1902250921
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301503926 Issued in MI
Practice address
21000 E 12 Mile Rd Ste 111
Saint Clair Shores, MI 48081-1156
Phone
(586) 779-7610
Fax
(586) 779-7685
NPI assigned
Apr 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Otolaryngology) Physician 207YS0012X 4301503926 MI
Otolaryngology Physician 207Y00000X 4301503926 MI Primary

Addresses

Primary practice location

21000 E 12 Mile Rd Ste 111
Saint Clair Shores, MI 48081-1156

Mailing address

21000 E 12 Mile Rd Ste 111
Saint Clair Shores, MI 48081-1156
Phone (586) 779-7610

Other practice location 1

601 Elmwood Ave Box 629
Rochester, NY 14642-8629
Phone (585) 276-5181

Other practice location 2

11900 E 12 Mile Rd Ste 210
Warren, MI 48093-3490
Phone (586) 582-7100

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
I20210410000043 MI Practitioner - Otolaryngology 5991092199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Ohio State University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, 246 clinicians

Practice addresses (Care Compare)

11900 E 12 Mile Rd
Suite 210
Warren, MI 48093-3490
Phone (248) 936-0067

21000 E 12 Mile Rd
Suite 111
Saint Clair Shores, MI 48081-1156
Phone (586) 779-7610

22201 Moross Rd
Suite 214
Detroit, MI 48236-2169
Phone (313) 343-7110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301503926MIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Otolaryngology CurrentSince Jun 1, 2021 Accepting new patients
Henry Ford Semi Medical Group CurrentSince Jun 1, 2021 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Jun 1, 2021 Accepting new patients
Henry Ford Semi Medical Group CurrentSince Jun 1, 2021 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
University Otolaryngology Associates Otolaryngology PastSince Aug 25, 2019 Accepting new patients
St. John Hospital Past Accepting new patients
Ascension Macomb Oakland Hospital Past Accepting new patients

Locations

22201 Moross Rd
Ste 214
Detroit, MI 48236
Phone (313) 343-7110

17770 Mack Ave
Grosse Pointe Shores, MI 48230
Phone (313) 882-1731

17900 23 Mile Rd
Ste 203
Macomb, MI 48044
Phone (586) 263-7400

21000 E 12 Mile Rd
Ste 111
St Clr Shores, MI 48081
Phone (586) 779-7610

30117 Schoenherr Rd
Ste 400
Warren, MI 48088
Phone (586) 552-4848

11900 E 12 Mile Rd
Ste 210
Warren, MI 48093
Phone (586) 558-4700

Interoperability endpoints

  • Direct secure messaging: dmartin760234@direct.hfhs.org

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902250921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 E 12 MILE RD STE 111",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811156",
            "telephone_number": "586-779-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 E 12 MILE RD STE 111",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811156",
            "telephone_number": "586-779-7610",
            "fax_number": "586-779-7685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Elmwood Ave Box 629",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146428629",
            "country_code": "US",
            "telephone_number": "585-276-5181",
            "fax_number": "585-271-8552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11900 E 12 Mile Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480933490",
            "country_code": "US",
            "telephone_number": "586-582-7100",
            "fax_number": "586-582-7101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DANIEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "MI",
            "license": "4301503926",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301503926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.