Individual provider Active NPI

David Machnacki, DO

  • Family Medicine Physician
  • Commerce TWP, MI
National Provider Identifier
1982644803
Registry record updated Mar 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101014897 Issued in MI
Practice address
2455 Union Lake Rd
Suite 101
Commerce TWP, MI 48382-3554
Phone
(248) 360-6000
Fax
(248) 360-6040
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2015

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 5101014897 MI Primary

Addresses

Primary practice location

2455 Union Lake Rd
Suite 101
Commerce TWP, MI 48382-3554

Mailing address

2455 Union Lake Rd
Suite 101
Commerce Township, MI 48382-3596
Phone (248) 363-1491

Other identifiers 1

IdentifierTypeStateIssuer
700H228210OtherMIBCBSM/BCN

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
I20051202000085 MI Practitioner - Family Practice 8123048386 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101014897MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan CurrentSince Jan 1, 2011 Accepting new patients
DMC Orthopedic Billing Associates LLC Past Accepting new patients
Hospital Health Care Inc. Family Medicine Past Accepting new patients

Locations

2455 Union Lake Rd
Ste 101
Commerce Twp, MI 48382
Phone (248) 360-6000

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

Organizations & group practices 3

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427068800000",
    "number": "1982644803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 UNION LAKE RD",
            "address_2": "SUITE 101",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483823596",
            "telephone_number": "248-363-1491",
            "fax_number": "248-363-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 UNION LAKE RD",
            "address_2": "SUITE 101",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483823554",
            "telephone_number": "248-360-6000",
            "fax_number": "248-360-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHNACKI",
        "first_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2015-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101014897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM/BCN",
            "identifier": "700H228210",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce TWP, MI

Sources for this page

Verify at the official NPI Registry.