DR. DAVID KOMASARA D.O. NPI 1861433302

NPI Information

NPI: 1861433302
Provider Name: DR. DAVID KOMASARA, D.O.
Classification: Emergency Medicine - 207PE0004X
Entity Type: Individual

Specialization: Emergency Medical Services

PECOS Registration: Yes

Address:
16001 W 9 MILE RD
SOUTHFIELD, MI
ZIP 48075
Phone: (248) 849-3000
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DR. David Komasara, D.O. is an emergency medical services emergency medicine in Southfield, MI with 34 years of experience. The provider is an emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. DR. David Komasara, D.O. NPI is 1861433302. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Graduation Year:1990

The provider's business location address is:

16001 W 9 MILE RD
SOUTHFIELD, MI
ZIP 48075-818
Phone: (248) 849-3000

The NPI 1861433302 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/8/2006 and was last updated on 11/4/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207PE0004X	Emergency Medicine	Emergency Medical Services	5101011074	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DK011074	OTHER	MICHIGAN	BC/BS OF MICHIGAN
2	M48310007	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN
3	F72589	MEDICARE UPIN	MICHIGAN
4	114713696	MEDICAID	MICHIGAN
5	114287137	MEDICAID	MICHIGAN
6	114274961	MEDICAID	MICHIGAN
7	113377937	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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