NPIMap

Individual provider Active NPI

Gary M Hollander, DO

  • Internal Medicine Physician
  • Walled Lake, MI
National Provider Identifier
1902896749
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101012793 Issued in MI
Practice address
620 N Pontiac TRL
Walled Lake, MI 48390-3443
Phone
(248) 624-4511
Fax
(248) 624-4408
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101012793 MI Primary

Addresses

Primary practice location

620 N Pontiac TRL
Walled Lake, MI 48390-3443

Mailing address

620 N Pontiac TRL
Walled Lake, MI 48390-3443
Phone (248) 624-4511

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
I20100916000894 MI Practitioner - Internal Medicine 0749264208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
VMD Primary Providers Eastern Michigan PCGroup PAC ID 9234480575, 63 clinicians

Practice addresses (Care Compare)

27275 Haggerty Rd
Suite 500
Novi, MI 48377-3635
Phone (734) 224-8317

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101012793MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Eastern Michigan, PC Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
Envision Medical Group PLLC CurrentSince Nov 1, 2014 Accepting new patients
Envision Medical Group PLLC CurrentSince Nov 1, 2014 Accepting new patients

Locations

42931 7 Mile Rd
Northville, MI 48167
Phone (248) 348-2442

39475 Lewis Dr
Ste 200
Novi, MI 48377
Phone (248) 471-0675

39475 Lewis Dr
Ste 130
Novi, MI 48377
Phone (248) 374-0502

27275 Haggerty Rd
Ste 500
Novi, MI 48377
Phone (248) 715-2423

620 N Pontiac Trl
Walled Lake, MI 48390
Phone (248) 624-4511

Interoperability endpoints

  • Direct secure messaging: gholland@direct.dmc.org
  • Direct secure messaging: gary.hollander.1@22064.direct.athenahealth.com
  • Direct secure messaging: ghollander58347@direct.hfhs.org
  • Direct secure messaging: ghollander@ghdp-mi.direct.office.nextgen.com
  • Direct secure messaging: gary.hollander.1@21803.direct.athenahealth.com

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.

Hospital & facility affiliations 8

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1902896749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N PONTIAC TRL",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903443",
            "telephone_number": "248-624-4511",
            "fax_number": "248-624-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N PONTIAC TRL",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903443",
            "telephone_number": "248-624-4511",
            "fax_number": "248-624-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLANDER",
        "first_name": "GARY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101012793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walled Lake, MI

Sources for this page

Verify at the official NPI Registry.