DR. MICHAEL S FOZO MD NPI 1114019627

NPI Information

  • NPI: 1114019627
  • Provider Name: DR. MICHAEL S FOZO, MD
  • Classification: Otolaryngology - 207YX0007X
  • Specialization: Plastic Surgery within the Head & Neck
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 21000 E 12 MILE RD
    SUITE 111
    SAINT CLAIR SHORES, MI
    ZIP 48081
  • Phone: (586) 779-7610

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NPI Details

DR. Michael S Fozo, MD is a plastic surgery within the head and neck otolaryngology in Saint Clair Shores, MI with 28 years of experience. The provider is an otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. DR. Michael S Fozo, MD NPI is 1114019627. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NEW YORK MEDICAL COLLEGE
Graduation Year:1997

The provider's business location address is:

21000 E 12 MILE RD
SUITE 111
SAINT CLAIR SHORES, MI
ZIP 48081-116
Phone: (586) 779-7610

The NPI 1114019627 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Diagnostic exam of nasal passages using an endoscope (HCPCS:31231)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Exam of the nose and throat using an endoscope (HCPCS:92511)
  • Upper gastrointestinal (GI) endoscopy for acid reflux (HCPCS:NAN12)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 9/29/2006 and was last updated on 10/5/2007.

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
1207YX0007XOtolaryngologyPlastic Surgery within the Head & NeckMF075562MICHIGANYes

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
10501379OTHERBLUE CARE NETWORK
24505853MEDICAIDMICHIGAN
3H68407OTHERHEALTH ALLIANCE PLAN
44339229OTHERAETNA
5136815OTHERCARE CHOICES
66029816OTHERCIGNA
7H68407MEDICARE UPINMICHIGAN
816056OTHERMCAR
9141736OTHERGREAT LAKES HEALTH PLAN
10P00014677OTHERRAILROAD MEDICARE
110N53990MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN

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: 3/30/2025

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