Ethan Bork, DO
NPI 1073204665 · Psychiatry Physician · Dearborn, MI
Enrolled with Medicare as Order and Referring Only - Psychiatry · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ethan Bork, DO is a Psychiatry Physician provider in Dearborn, MI (NPI 1073204665).
Provider details
- NPI number
- 1073204665
- Entity type
- Individual
- Primary specialty
- Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- 5151016273APP23 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-05-16
- Last updated
- 2023-05-16
- Certified
- 2023-05-15
Frequently asked questions
- What is Ethan Bork's NPI number?
- Ethan Bork's National Provider Identifier (NPI) is 1073204665, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ethan Bork's specialty?
- Ethan Bork is listed in the NPPES registry with a primary specialty of Psychiatry Physician (Allopathic & Osteopathic Physicians).
- Where is Ethan Bork located?
- Ethan Bork's practice location on file with NPPES is 18101 Oakwood Blvd, Dearborn, MI 48124-4089.
- What is Ethan Bork's phone number?
- The practice phone number listed in the NPPES registry for Ethan Bork is (313) 593-7000.
- Does Ethan Bork accept Medicare?
- Ethan Bork is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Ethan Bork's NPI active?
- Yes — Ethan Bork's NPI (1073204665) is active in the NPPES registry as of the last update on 2023-05-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.