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DR. DOUGLAS W POFF DO
NPI 1013972819
Family Medicine in Fowler, MI

Active since April 18, 2006PECOS Enrolled
11017 WEST THIRD ST, FOWLER, MI 48835(989) 593-2525(989) 593-3385 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Douglas W Poff Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DOUGLAS W POFF DO (NPI 1013972819) is an individual family medicine provider in Fowler, Michigan, licensed in Michigan (5101008254) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013972819
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DOUGLAS W POFFCredential: DO
Location Address11017 WEST THIRD STFowler, MI 48835
Mailing Address406 E Elm St, Po Box 879Carson City, MI 48811 · (989) 584-3971 · Fax (989) 584-3729
Phone(989) 593-2525
Fax(989) 593-3385
Sole ProprietorNo
Enumeration DateApril 18, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1013972819 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 5101008254
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
11017 WEST THIRD ST, Fowler, MI 48835
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Other Identifiers 1

Medicaid1442562MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Douglas W Poff Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Douglas Poff reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sparrow Carson Hospital
Same address
Family Medicine
11017 W 3RD ST
Fowler, MI 48835
  • Reassigned Medicare billing, Michigan enrollment
  • 215 clinicians in this Medicare group
NPI 1619124328 (989) 593-2525

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
104 services57 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
24 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48835 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
52%221 patients2/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
82%261 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 12

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
13 suppliers33 claims88 services$6.35 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
11 suppliers16 claims20 services$1.20 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
4 suppliers13 claims13 services$75.27 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
4 suppliers13 claims34 services$30.94 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
7 suppliers11 claims11 services$15.87 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
7 suppliers18 claims102 services$1.58 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. L JOHN OSBORN DO
Family Medicine
11017 WEST THIRD ST
FOWLER, MI 48835
Clinton County (989) 593-2525

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Poff's NPI number?

The NPI number for Douglas Poff is 1013972819. It was assigned to this individual provider in the NPPES registry on April 18, 2006.

Where is Douglas Poff located?

Douglas Poff practices at 11017 West Third St, Fowler, MI 48835. The listed phone number is (989) 593-2525.

What is Douglas Poff's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Douglas Poff enrolled in Medicare?

Yes. Douglas Poff is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Douglas Poff's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Douglas Poff reassigns Medicare benefits to Sparrow Carson Hospital (Fowler, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Douglas Poff's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Douglas Poff accept?

Health plans from Priority Health list Douglas Poff as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Douglas Poff was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.