Individual provider Active NPI

Juan Sebastian Cifuentes Munoz, MD

  • Student in an Organized Health Care Education/Training Program
  • Ann Arbor, MI
National Provider Identifier
1174374060
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4351054005 Issued in MI
Practice address
1500 E Medical Center Drive, SPC 5856
FCVC 3Rd Floor, Reception B
Ann Arbor, MI 48109-5856
Phone
(734) 936-5850
Fax
(734) 647-4285
NPI assigned
Mar 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351054005 MI Primary

Addresses

Primary practice location

1500 E Medical Center Drive, SPC 5856
FCVC 3Rd Floor, Reception B
Ann Arbor, MI 48109-5856

Mailing address

1500 E Medical Center Drive
5346 CVC, SPC 5867
Ann Arbor, MI 48109-5867
Phone (734) 647-9867

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250707001074 MI Order and Referring Only - Vascular SurgeryPractitioner - Vascular Surgery 7315387826

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351054005MIMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1174374060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE",
            "address_2": "5346 CVC, SPC 5867",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095867",
            "telephone_number": "734-647-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE, SPC 5856",
            "address_2": "FCVC 3RD FLOOR, RECEPTION B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095856",
            "telephone_number": "734-936-5850",
            "fax_number": "734-647-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIFUENTES MUNOZ",
        "first_name": "JUAN",
        "middle_name": "SEBASTIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-28",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351054005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.