Individual provider Active NPI

Daniel Agrusa, AU.D.

  • Audiologist
  • Macomb, MI
National Provider Identifier
1962790097
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601000585 Issued in MI
Practice address
49306 Flint CT.
Macomb, MI 48044
Phone
(586) 524-1909
NPI assigned
Jul 11, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1601000585 MI Primary

Addresses

Primary practice location

49306 Flint CT.
Macomb, MI 48044

Mailing address

49306 Flint CT.
Macomb, MI 48044
Phone (586) 524-1909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111104000141 MI Practitioner - Qualified Audiologist 8224201348 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1601000585MIMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC Audiologist CurrentSince Jul 22, 2019 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Feb 1, 2012 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Feb 1, 2012 Accepting new patients
Audiology Services Company USA, LLC CurrentSince Jul 22, 2019 Accepting new patients
Lakeshore Ear Nose and Throat Center PC Past Accepting new patients

Locations

43750 Garfield Rd
Bldg B
Clinton Twp, MI 48038
Phone (248) 620-0044

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

134 W University Dr
Ste 203
Rochester, MI 48307
Phone (248) 608-8881

30475 Woodward Ave
Royal Oak, MI 48073
Phone (248) 288-0440

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

113 E Long Lake Rd
Ste B
Troy, MI 48085
Phone (248) 435-6811

4835 Haggerty Rd
West Bloomfield, MI 48323
Phone (248) 356-7773

2501 Cottontail Ln
Somerset, NJ 08873
Phone (732) 529-7120

Organizations & group practices 6

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": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1962790097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49306 FLINT CT.",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "48044",
            "telephone_number": "586-524-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49306 FLINT CT.",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "48044",
            "telephone_number": "586-524-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGRUSA",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-11",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.