Individual provider Active NPI

Daniel DJ Megler, MD

  • Otolaryngology Physician
  • Saint Clair Shores, MI
National Provider Identifier
1922190552
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
DM031809 Issued in MI
Practice address
21000 E 12 Mile Rd
Suite 111
Saint Clair Shores, MI 48081-1116
Phone
(586) 779-7640
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X DM031809 MI Primary

Addresses

Primary practice location

21000 E 12 Mile Rd
Suite 111
Saint Clair Shores, MI 48081-1116

Mailing address

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

Other identifiers 11

IdentifierTypeStateIssuer
102734OtherCARE CHOICES
B44170OtherHEALTH ALLIANCE PLAN
040008565OtherRAIL ROAD MEDICARE
108447OtherGREAT LAKES HEALTH
1313897MedicaidMI
4033125OtherAETNA
C4748OtherMCAR
040E061920OtherMIBLUE SHIELD GROUP
2438275001OtherCIGNA
0405032191OtherBLUE CROSS BLUE SHIELD
0503219OtherBLUE CARE NETWORK

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
I20101214000876 MI Practitioner - Otolaryngology 2466433081 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DM031809MIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Feb 1, 2012 Accepting new patients
Henry Ford Health St. John Hospital Otolaryngology CurrentSince Feb 1, 2012 Accepting new patients
Lakeshore Ear Nose and Throat Center PC Otolaryngology CurrentSince Nov 26, 2018 Accepting new patients
Lakeshore Ear Nose and Throat Center PC Otolaryngology Current Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients

Locations

43750 Garfield Rd
Ste 101
Clinton Twp, MI 48038
Phone (586) 263-7400

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

17900 23 Mile Rd
Ste 205
Macomb, MI 48044
Phone (313) 885-6367

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

Interoperability endpoints

  • Direct secure messaging: dmegler252600@direct.hfhs.org

Organizations & group practices 5

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1922190552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 E 12 MILE RD",
            "address_2": "STE 111",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-779-7610",
            "fax_number": "586-445-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 E 12 MILE RD",
            "address_2": "SUITE 111",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811116",
            "telephone_number": "586-779-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEGLER",
        "first_name": "DANIEL",
        "middle_name": "DJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "DM031809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "102734",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "B44170",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "040008565",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH",
            "identifier": "108447",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1313897",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4033125",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCAR",
            "identifier": "C4748",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP",
            "identifier": "040E061920",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2438275001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0405032191",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "0503219",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.