NPIMap

Individual provider Active NPI

Nathan Samuel Taylor, MD

  • Surgery of the Hand (Plastic Surgery) Physician
  • Marquette, MI
National Provider Identifier
1013111897
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X
License
4301096709 Issued in MI
Practice address
1414 W Fair Ave
Suite 190
Marquette, MI 49855-2675
Phone
(906) 225-1321
Fax
(905) 228-9371
NPI assigned
Jun 13, 2007
Last updated
Feb 29, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 4301096709 MI
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X 4301096709 MI Primary

Addresses

Primary practice location

1414 W Fair Ave
Suite 190
Marquette, MI 49855-2675

Mailing address

1414 W Fair Ave
Suite 190
Marquette, MI 49855-2675
Phone (906) 225-1321

Other identifiers 2

IdentifierTypeStateIssuer
1013111897MedicaidMI
0520253OtherMIBLUE CROSS BLUE SHIELD MI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110810000607 MI Practitioner - Hand SurgeryPractitioner - Plastic and Reconstructive Surgery 1052580966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Plastic and Reconstructive Surgery
Education
Georgetown University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1414 W Fair Ave
Marquette, MI 49855-5406
Phone (906) 225-1321

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301096709MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Surgery Associates of Marquette PC CurrentSince Aug 1, 2011 Accepting new patients
Orthopaedic Surgery Associates of Marquette PC Surgery of the Hand CurrentSince Aug 1, 2011 Accepting new patients
South Shore Anesthesia Staffing PastSince Jul 27, 2020 Accepting new patients
Upper Michigan Associates LLC PastSince May 10, 2020 Accepting new patients

Locations

1414 W Fair Ave
Ste 190
Marquette, MI 49855
Phone (906) 225-1321

1414 W Fair Ave
Ste 235
Marquette, MI 49855
Phone 9062732223103

Interoperability endpoints

  • Direct secure messaging: 05nathan@acops1752.srs-direct.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1013111897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 190",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-1321",
            "fax_number": "905-228-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 190",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-1321",
            "fax_number": "905-228-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "NATHAN",
        "middle_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301096709",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "MI",
            "license": "4301096709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013111897",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "0520253",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.