Individual provider Active NPI

Jeremy J Fischer, D.O.

  • Family Medicine Physician
  • Clinton TWP, MI
National Provider Identifier
1962421883
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101015337 Issued in MI
Practice address
15400 19 Mile Rd
Ste 150
Clinton TWP, MI 48038-6327
Phone
(586) 263-3400
Fax
(586) 412-3670
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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 5101015337 MI Primary

Addresses

Primary practice location

15400 19 Mile Rd
Ste 150
Clinton TWP, MI 48038-6327

Mailing address

15400 19 Mile Rd
Ste. 150
Clinton TWP, MI 48038-6327
Phone (586) 263-3400

Other identifiers 1

IdentifierTypeStateIssuer
4840465MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfischer9930@direct.hfhs.org

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
I20050920001176 MI Practitioner - Family Practice 1658305537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

15717 15 Mile Rd
Clinton Township, MI 48035-2101

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101015337MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Aug 1, 2005 Accepting new patients
Henry Ford Macomb Hospital Corporation Family Medicine Current Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Aug 1, 2005 Accepting new patients
Henry Ford Macomb Hospital Corporation Family Medicine Current Accepting new patients

Locations

80650 Van Dyke Rd
Bruce Twp, MI 48065
Phone (810) 798-6410

15400 19 Mile Rd
Clinton Township, MI 48038
Phone (586) 228-7865

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

15400 19 Mile Rd
Ste 150
Clinton Twp, MI 48038
Phone (586) 263-3400

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

Interoperability endpoints

  • Direct secure messaging: jfischer9930@direct.hfhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1962421883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15400 19 MILE RD",
            "address_2": "STE. 150",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386327",
            "telephone_number": "586-263-3400",
            "fax_number": "586-412-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 19 MILE RD",
            "address_2": "STE 150",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386327",
            "telephone_number": "586-263-3400",
            "fax_number": "586-412-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "JEREMY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101015337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4840465",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfischer9930@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

Verify at the official NPI Registry.