Stanley Anthony Materka, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101007669 Issued in MI

Practice address

1000 Harrington Blvd
Mt Clemens, MI 48043

Phone

(586) 493-8000

NPI assigned

Oct 4, 2006

Last updated

May 16, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Macomb Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Mount Clemens, MI
  • NPI 1609235217
  Medicare reassignment NPD
• Observation Physicians of Macomb PLLC

  • Emergency Medicine Physician
  • Mount Clemens, MI
  • NPI 1144855941
  Medicare reassignment NPD
• Stanley a. Materka, DO PC

  • Emergency Medicine Physician
  • Mount Clemens, MI
  • NPI 1760546410
  Authorized official Same address or phone
• Kalamazoo Emergency Associates, PLC

  • Emergency Medicine Physician
  • Kalamazoo, MI
  • NPI 1942251244
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1932294881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8836",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49518",
            "telephone_number": "866-898-7139",
            "fax_number": "616-975-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON BLVD",
            "city": "MT CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "586-493-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATERKA",
        "first_name": "STANLEY",
        "middle_name": "ANTHONY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101007669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0155000555",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111389975",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura J Martin, LPC
• Adrianna Rose Martinez
• Dwight A Mason
• Mohammed T Masri, MD
• Elizabeth Masserang, LMSW
• Sebastian Matti
• Jacob Matthew Mattia, DPT
• Michael John Mattingly, DO
• Adam Matynowski, DO
• Brittany Nicole Maul

• Emergency Medicine Physician in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.