Active NPI
Mary Jane Callegari, MD
- Pediatrics Physician
- Ypsilanti, MI
National Provider Identifier
1104886720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301046303
- Practice address
- 5301 E Huron River Dr
Dept of Pediatrics
Ypsilanti, MI 48197-1051 - Phone
- (734) 712-3325
- NPI assigned
- Mar 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301046303 | MI | Primary |
Addresses
Primary practice location
5301 E Huron River Dr
Dept of Pediatrics
Ypsilanti, MI 48197-1051
Mailing address
5301 E Huron River Dr
Dept of Pediatrics
Ypsilanti, MI 48197-1051
Phone (734) 712-3325
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1929 849 | Medicaid | MI | |
| OH 16115045 | Medicaid | MI | |
| 700H161150 | Other | MI | BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161104001846 | OH | Order and Referring Only - Pediatric Medicine | 5597773903 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454284800000",
"number": "1104886720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5301 E HURON RIVER DR",
"address_2": "DEPT OF PEDIATRICS",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481971051",
"telephone_number": "734-712-3325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 E HURON RIVER DR",
"address_2": "DEPT OF PEDIATRICS",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481971051",
"telephone_number": "734-712-3325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALLEGARI",
"first_name": "MARY",
"middle_name": "JANE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-27",
"last_updated": "2016-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301046303",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1929 849",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "OH 16115045",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BS",
"identifier": "700H161150",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.