Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1457385072 Individual Practitioner Male Practitioner

Dr. Jack S Elder , MD

Urology • Detroit, MI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Jack Elder, MD is a certified Urology practicing in Detroit, MI. With approximately 50 years of clinical experience since graduating from University Of Oklahoma College Of Medicine in 1976, Dr. Elder delivers high-quality medical care to the local community at 2799 W GRAND BLVD.

Dr. Elder is affiliated with Massachusetts General Physicians Organization Inc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

2799 W Grand Blvd

Detroit, MI 482022608

Telephone 3139162600
Fax 3139169539
Associated Practice Facility / Clinic
🏢 Henry Ford Health System Facility NPI 1053386334

Medicare Profile & Education

Medical School

University Of Oklahoma College Of Medicine

Graduation Year

1976

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Detroit, MI

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
50 Yrs +23.2 yrs vs City Avg
City Avg: 26.8 Yrs
State Avg: 25.6 Yrs
Regional Practice Density
45 Specialists

Practicing in Detroit, MI (479 Statewide)

Telehealth Adoption Rate
40.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Elder (50 Years) 50 Yrs
Detroit Specialty Average (26.8 Years) 26.8 Yrs

Medical Specialties & State Licenses

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License OH 35-053721

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Urology

NUCC Taxonomy Code: 208800000X

State License MI 4301072611

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
001953975002 (PA)
Medicaid State Provider ID
5196618 (MI)
Medicaid State Provider ID
0633587 (OH)
Commercial Insurance / Payer ID Group Npi
1396817714 (MI)
Commercial Insurance / Payer ID Bcbs
020H277290 (MI)
Commercial Insurance / Payer ID Railroad Medicare
P00388789 (OH)
Commercial Insurance / Payer ID Uhc
1900370 (OH)
Commercial Insurance / Payer ID Anthem
000000026163 (OH)

Hospital & Practice Group Affiliations

Massachusetts General Physicians Organization Inc

55 Fruit St, Boston, MA 021142696

Phone: 6177240287

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Brent Griffith , MD

Radiology - Diagnostic Radiology

NPI 1003077207

Doctor of Medicine (M.D.)

Dr. Kanika Khanna , MD

Radiology - Diagnostic Radiology

NPI 1003120528

Doctor of Medicine (M.D.)

Dr. Fadl Chokr , MD

Family Medicine

NPI 1003158171

Doctor of Medicine (M.D.)

Dr. Avi Cohen , MD

Internal Medicine - Pulmonary Disease

NPI 1003173667

Doctor of Medicine (M.D.)

Lindsey Aurora

Internal Medicine - Cardiovascular Disease

NPI 1003200056
Kyle Krupa

Nurse Anesthetist, Certified Registered

NPI 1003218496

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 09, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location January 09, 2013

Registered at 2799 W GRAND BLVD, DETROIT, MI 482022608 (Tel: 3139162600)

📍
Updated Business Mailing Address January 09, 2013

Registered at 1 FORD PL, 2E, DETROIT, MI 482023450 (Tel: 3139162600)

👤
Provider Name / Credentials Updated January 09, 2013

Recorded as JACK ELDER, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 09, 2013

Urology (License #35-053721 in OH)

🟢
Initial NPI Registration & Enumeration July 10, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1457385072
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 10, 2006
Last Update: January 09, 2013
Sole Proprietor: No

Mailing Address

1 Ford Pl, 2e

Detroit, MI 482023450

Phone: 3139162600

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.