Individual provider Active NPI

Michael Joseph Van Sickle, DO

  • Family Medicine Physician
  • Farmington Hills, MI
National Provider Identifier
1962330290
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5151018067 Issued in MI
Practice address
28100 Grand River Ave Ste 313
Farmington Hills, MI 48336-5970
Phone
(947) 521-7150
Fax
(248) 426-2473
NPI assigned
May 8, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5151018067 MI Primary

Addresses

Primary practice location

28100 Grand River Ave Ste 313
Farmington Hills, MI 48336-5970

Mailing address

28100 Grand River Ave Ste 313
Farmington Hills, MI 48336-5970
Phone (947) 521-7150

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
I20260604001908 MI Order and Referring Only - Family PracticePractitioner - Family Practice 4486125085

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5151018067MIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1778198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1962330290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28100 GRAND RIVER AVE STE 313",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365970",
            "telephone_number": "947-521-7150",
            "fax_number": "248-426-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28100 GRAND RIVER AVE STE 313",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365970",
            "telephone_number": "947-521-7150",
            "fax_number": "248-426-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN SICKLE",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-08",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151018067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.