DR. DEON DAVID MIDDLEBROOK MD NPI 1508898123

NPI Information

  • NPI: 1508898123
  • Provider Name: DR. DEON DAVID MIDDLEBROOK, MD
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • CLIA Number: 23D2144251
  • Address: 20176 LIVERNOIS AVE
    DETROIT, MI
    ZIP 48221
  • Phone: (313) 864-7000

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NPI Details

DR. Deon David Middlebrook, MD is a specialist in Detroit, MI with 40 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Deon David Middlebrook, MD NPI is 1508898123. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1985

The provider's business location address is:

20176 LIVERNOIS AVE
DETROIT, MI
ZIP 48221-346
Phone: (313) 864-7000
Fax: (313) 864-5423

The NPI 1508898123 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 CLIA number assigned to this NPI record is 23D2144251 - other - urgent care with a certificate type of Certificate of Waiver.

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.

  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Dialysis services, 4 or more physician visits per month (20 years or older) (HCPCS:90960)
  • Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)
  • Hemodialysis procedure with physician evaluation (HCPCS:90935)
  • Hospital discharge day management, 30 minutes or less (HCPCS:99238)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)

The enumeration date for this NPI number is 7/6/2006 and was last updated on 9/14/2023.

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
1207RN0300XInternal MedicineNephrology4301053010MICHIGANNo
2174400000XSpecialistDM053010MICHIGANYes

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
1102889716MEDICAIDMICHIGAN

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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