Individual provider Active NPI

Dean Moscovic, DO

  • Pediatrics Physician
  • Clarkston, MI
National Provider Identifier
1952309718
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101014251 Issued in MI
Practice address
5701 Bow Pointe Drive
Suite 100
Clarkston, MI 48346-3199
Phone
(248) 625-2621
Fax
(248) 625-2622
NPI assigned
Jul 14, 2005
Last updated
Jun 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DM014251 MI
Pediatrics Physician 208000000X 5101014251 MI Primary

Addresses

Primary practice location

5701 Bow Pointe Drive
Suite 100
Clarkston, MI 48346-3199

Mailing address

5701 Bow Pointe Drive
Suite 100
Clarkston, MI 48346-3199
Phone (248) 625-2621

Other identifiers 1

IdentifierTypeStateIssuer
4483344MedicaidMI

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
I20040922000866 MI Practitioner - Internal Medicine 5092783506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

5701 Bow Pointe Dr
Suite 100
Clarkston, MI 48346-3199
Phone (248) 625-2621

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DM014251MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC Internal Medicine CurrentSince Sep 1, 2013 Accepting new patients
Clarkston Urgent Care PLC Current Accepting new patients
McLaren Community Based Primary Care Group Internal Medicine CurrentSince Dec 31, 2025 Accepting new patients
McLaren Community Based Primary Care Group CurrentSince Dec 31, 2025 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Sep 1, 2013 Accepting new patients

Locations

5625 Water Tower Pl
Ste 200
Clarkston, MI 48346
Phone (248) 625-2621

5625 Water Tower Pl
Ste 300
Clarkston, MI 48346
Phone (248) 625-2621

5701 Bow Pointe Dr
Ste 1
Clarkston, MI 48346
Phone (248) 625-2273

5701 Bow Pointe Dr
Ste 100
Clarkston, MI 48346
Phone (248) 625-2621

5701 Bow Pointe Dr
Ste 120
Clarkston, MI 48346
Phone (248) 625-2273

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

834 S Lapeer Rd
Ste 100
Oxford, MI 48371
Phone (248) 384-8320

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

Interoperability endpoints

  • Direct secure messaging: dean.moscovic.1@3928.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1952309718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DRIVE",
            "address_2": "SUITE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463199",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DRIVE",
            "address_2": "SUITE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463199",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSCOVIC",
        "first_name": "DEAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "DM014251",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101014251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4483344",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.