DR. MICHAEL S FOZO (MD) – Plastic Surgery within the Head & Neck (Otolaryngology) Physician, NPI 1114019627

DR. MICHAEL S FOZO (MD) is a healthcare provider. based in St clair shores, Michigan. specializing in OTOLARYNGOLOGY, PLASTIC AND RECONSTRUCTIVE SURGERY. They hold the professional credentials MD. They hold a License No. MF075562 (MI). The NPI Number for DR. MICHAEL S FOZO (MD) is 1114019627

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL S FOZO (MD)
NPI
1114019627
Phone
(586) 779-7610
Address
21000 E 12 MILE RD
Enumeration Date
29 September 2006
Last Update Date
5 October 2007

Doctor Profile

Medical School Name
NEW YORK MEDICAL COLLEGE
Secondary Phone
5867530011
Graduation Year
1997 (29 years ago)
PAC ID
4789871971
Group Practice PAC ID
3173424082
Professional Enrollment ID
I20101214000912
Address ID
MI482362148DE22101RDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

428 OTOLARYNGOLOGY in MI

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Provider Addresses for DR. MICHAEL S FOZO (MD)

  • Saint John Medical Center, Saint Clair Shores, 21000, East 12 Mile Road, Saint Clair Shores, Macomb County, Michigan, 48081, United States

    STE 111

    ST CLAIR SHORES, MI 48081

    Phone: (586) 779-7610

    Fax: (586) 445-2523

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $280.

Total Amount is formed as General ($280) + Research ($0) + Ownership ($0) = $280.

Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Medtronic, Inc. ($136).

Total Amount

$280

General + Research + Ownership

Payments

3

Total payment records

General Amount

$280

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-12-14

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101214000912IOtolaryngologyMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes6960$0
99214Established patient office or other outpatient visit, 30-39 minutes5444$0
99204New patient office or other outpatient visit, 45-59 minutes5252$0
31231Diagnostic exam of nasal passages using an endoscope4538$0
99203New patient office or other outpatient visit, 30-44 minutes4444$0
View full utilization report →

Insurance plans in this area (ZIP 48081)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173424082View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)IL
-MI
-MI
-MI
N E U R O S U R G E R YMI
H E M A T O L O G Y/ O N C O L O G YMO
-MI
Cardiovascular Disease (Cardiology), Interventional Cardiology, Cardiovascular Disease (Cardiology)MI
-MI
O B S T E T R I C S/ G Y N E C O L O G YMI

Reviews

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Frequently asked questions

Can I use this page to confirm DR. MICHAEL S FOZO (MD)'s NPI?
Yes. DR. MICHAEL S FOZO (MD) is listed with NPI 1114019627 in the public NPI dataset.
Is DR. MICHAEL S FOZO (MD) listed as active for patients and plans?
The listing shows DR. MICHAEL S FOZO (MD) as active in the NPI system.
What is DR. MICHAEL S FOZO (MD)'s specialty?
The listing groups DR. MICHAEL S FOZO (MD) with Plastic Surgery within the Head & Neck (Otolaryngology) Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DR. MICHAEL S FOZO (MD)?
DR. MICHAEL S FOZO (MD)'s geographic hint is St Clair Shores, Michigan in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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