Individual provider Active NPI

David G Fry, MD

  • Diagnostic Radiology Physician
  • Warren, MI
National Provider Identifier
1992723332
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
053431 Issued in MI
Practice address
11800 E Twelve Mile Road
Warren, MI 48093
Phone
(586) 573-5060
Fax
(586) 573-5197
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 053431 MI Primary

Addresses

Primary practice location

11800 E Twelve Mile Road
Warren, MI 48093

Mailing address

11800 E Twelve Mile Road
Warren, MI 48093
Phone (586) 573-5060

Other identifiers 1

IdentifierTypeStateIssuer
3075927MedicaidMI

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
I20040315001363 MI Practitioner - Diagnostic Radiology 1355230392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Radiology Services PCGroup PAC ID 4284546516, 252 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 363-7272

25044 Hadlock Dr
Novi, MI 48374-2553
Phone (616) 363-7272

763 Lake Dr
Coldwater, MI 49036-8516
Phone (616) 363-7272

95 Mapleton Rd
Grosse Pointe Farms, MI 48236-3614
Phone (616) 363-7272

Hospital & facility affiliations

  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075

Merit-based Incentive Payment System (MIPS)

Final score
90.33 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

Merit-based Incentive Payment System (MIPS)

Final score
95.17 of 100Reported as group
Quality
91.34
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
053431MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Radiology Services PC Diagnostic Radiology CurrentSince May 1, 2021 Accepting new patients
Henry Ford Health Macomb Oakland Hospital Current Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Oct 1, 2010 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Oct 1, 2010 Accepting new patients
Michigan Orthopaedic Institute, P.C. PastSince Nov 30, 2015 Accepting new patients
Harper Metro CT Partnership Diagnostic Radiology Past Accepting new patients

Locations

4260 Van Dyke Rd
Ste 10
Almont, MI 48003
Phone (810) 798-3994

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

3264 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 391-6001

844 Washington Ave
Holland, MI 49423
Phone (616) 355-3820

44720 Van Dyke Ave
#G
Utica, MI 48317
Phone (586) 323-7148

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: dfry160424@direct.covenanthealthcare.com
  • Direct secure messaging: dfry1127330@direct.hfhs.org

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.

Hospital & facility affiliations 8

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1992723332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 E TWELVE MILE ROAD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-5060",
            "fax_number": "586-573-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E TWELVE MILE ROAD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-5060",
            "fax_number": "586-573-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "DAVID",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "053431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3075927",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.