Vito Matteo Agrusa, DO
Individual provider Active NPI Family Medicine Physician · Southgate, MI
NPI 1992371009 · NPPES record last updated Jul 12, 2024
Key facts
- NPI
- 1992371009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5101027836 (MI)
- Practice address
- 14319 Dix Toledo Rd
Southgate, MI 48195-2506 - Phone
- (734) 285-0677
- NPI assigned
- May 29, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Michigan State University College of Osteopathic Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Oakwood Ambulatory LLC
Practice addresses (Care Compare)
14319 Dix Toledo Rd
Southgate, MI 48195-2506
Phone (734) 285-0677
201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065
Hospital & facility affiliations
- Beaumont Hospital - Dearborn
- Corewell Health Trenton Hospital
- Beaumont Hospital - Taylor
- Beaumont Hospital Royal Oak
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.72 of 100
- Quality
- 87.24
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240805001408 | MI | Practitioner - Family Practice | 3577963487 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101027836 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakwood Ambulatory, LLC | Current |
Accepting new patients | |
| Oakwood Ambulatory LLC | Family Medicine | Current |
Accepting new patients |
Locations
201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065
26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860
14319 Dix Toledo Rd
Southgate, MI 48195
Phone (734) 285-0677
33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042
Interoperability endpoints
- vagrusa966251@direct.beaumont.edu
- vagrusa1222185@epic00.shdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101027836 | MI | Yes |
Addresses
Primary practice location
14319 Dix Toledo Rd
Southgate, MI 48195-2506
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1863
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | vagrusa966251@direct.beaumont.edu |
Other providers in Southgate, MI
- Mikayla Adams
- Tina Adkins
- Admire Dental of Michigan PLLC
- Adult & Family Services
- Nalini Agarwal
- Julia Aguilar
- Ahmad R Zeibo MD PLLC
- Khalid Manzoor Ahmed
- Swann Moane Ahmed
- Leila Akhavan Shahr Ashoub
All providers in Southgate, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.