Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. EVAN BRADLEY FONGER MD
NPI 1467655886
Family Medicine in Detroit, MI

Q: What is Evan Fonger's NPI number?

The NPI number for Evan Fonger is 1467655886. It was assigned to this individual provider in the NPPES registry on June 6, 2007.

Q: What is Evan Fonger's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Evan Fonger was last updated on October 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days 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.

Active since June 06, 2007PECOS Enrolled

400 MACK AVENUE, DETROIT, MI 48201(313) 578-5000(313) 578-6379 Get Directions Write a Review

NPPES record last updated: October 9, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 9, 2026, Apr 13, 2026, Apr 16, 2019 (3 updates tracked since 2019).

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About Dr. Evan Bradley Fonger Md NPPES

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

DR. EVAN BRADLEY FONGER MD (NPI 1467655886) is an individual family medicine provider in Detroit, Michigan, licensed in Michigan (4301087817) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in Ann Arbor.

NPPES Registry Identity

NPI1467655886

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. EVAN BRADLEY FONGERCredential: MD

Location Address400 MACK AVENUEDetroit, MI 48201

Mailing Address400 Mack AveDetroit, MI 48201-2136 · (313) 578-5000 · Fax (313) 578-6379

Phone(313) 578-5000

Fax(313) 578-6379

Sole ProprietorNo

Enumeration DateJune 6, 2007

Last NPPES UpdateOctober 9, 20263 updates tracked since enumeration

NPPES CertifiedOctober 9, 2026

✔ NPI 1467655886 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 4301087817

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.

Also ListedInternal Medicine · Hospice and Palliative MedicineTaxonomy 207RH0002X · License 4301087817 (MI)

400 MACK AVENUE, Detroit, MI 48201

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Secondary Practice Location 1

Location 12366 Oak Valley DrAnn Arbor, MI 48103-8944 · Phone (888) 247-5701 · Fax (888) 466-7578

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, 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. Evan Bradley Fonger Md 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 Reassignments

Medicare enrollment records show Evan Fonger reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mymichigan Medical Group

96 mi

Psychiatry

4201 CAMPUS RIDGE DR STE 2700
Midland, MI 48640

Reassigned Medicare billing, Michigan enrollment
197 clinicians in this Medicare group

NPI 1568412948 (989) 839-3385

Wings Of Hope Hospice And Palliative Care Inc.

144 mi

Hospice and Palliative Medicine

530 LINN ST
Allegan, MI 49010

Reassigned Medicare billing, Michigan enrollment
4 clinicians in this Medicare group

NPI 1306249073 (269) 686-8659

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48201 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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.

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 Evan Fonger's NPI number?

The NPI number for Evan Fonger is 1467655886. It was assigned to this individual provider in the NPPES registry on June 6, 2007.

Where is Evan Fonger located?

Evan Fonger practices at 400 Mack Avenue, Detroit, MI 48201. The listed phone number is (313) 578-5000.

What is Evan Fonger's specialty?

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

Is Evan Fonger enrolled in Medicare?

Yes. Evan Fonger is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Evan Fonger's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Evan Fonger reassigns Medicare benefits to 2 organizations: Mymichigan Medical Group (Midland, MI) and Wings Of Hope Hospice And Palliative Care Inc. (Allegan, MI). Each 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 Evan Fonger's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Evan Fonger accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Evan Fonger 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 Evan Fonger was last updated on October 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days 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.