NPIMap

Organization Active NPI

Advanced Wound Care and Hyperbaric Medicine of Michigan PC

  • Internal Medicine Physician
  • West Bloomfield, MI
National Provider Identifier
1093184129
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ADVANCED WOUND CARE AND HYPERBARIC MEDICINE OF MICHIGAN PC
Practice address
7071 Orchard Lake Rd
Suite 333
West Bloomfield, MI 48322-3613
Phone
(734) 427-9440
NPI assigned
Sep 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Authorized official

Name
Dr. Jose Salgado Evangelista III, MDNPI 1306029186
Title
Owner
Phone
(248) 890-9995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

7071 Orchard Lake Rd
Suite 333
West Bloomfield, MI 48322-3613

Mailing address

7071 Orchard Lake Rd
Suite 333
West Bloomfield, MI 48322-3613

Other practice location 1

31182 Novi Road
Novi, MI 48377-4545
Phone (248) 895-4231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151103001952 MI Part B Supplier - Clinic/Group Practice 0749590743 Receives reassigned benefits from 4 practitioners
Practice locations: Novi, MI; Wayne, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1093184129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7071 ORCHARD LAKE RD",
            "address_2": "SUITE 333",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7071 ORCHARD LAKE RD",
            "address_2": "SUITE 333",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223613",
            "telephone_number": "734-427-9440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31182 Novi Road",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483774545",
            "country_code": "US",
            "telephone_number": "248-895-4231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED WOUND CARE AND HYPERBARIC MEDICINE OF MICHIGAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-18",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "EVANGELISTA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "SALGADO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-890-9995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.