Active NPI
Sandra Kay Mastrogiacomo
- Contractor
- Lincoln Park, MI
National Provider Identifier
1184036022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 1759 Markese Ave
Lincoln Park, MI 48146-3254 - Phone
- (313) 585-6072
- NPI assigned
- May 27, 2014
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
1759 Markese Ave
Lincoln Park, MI 48146-3254
Mailing address
1759 Markese Ave
Lincoln Park, MI 48146-3254
Phone (313) 585-6072
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401148800000",
"number": "1184036022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1759 MARKESE AVE",
"city": "LINCOLN PARK",
"state": "MI",
"postal_code": "481463254",
"telephone_number": "313-585-6072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1759 MARKESE AVE",
"city": "LINCOLN PARK",
"state": "MI",
"postal_code": "481463254",
"telephone_number": "313-585-6072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTROGIACOMO",
"first_name": "SANDRA",
"middle_name": "KAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-27",
"last_updated": "2014-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.