Alfonso Acosta MD PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301064369 Issued in MI

Legal business name

ALFONSO ACOSTA MD PC

Practice address

7173 Ilanaway Dr
W Bloomfield, MI 48324-2493

Phone

(586) 929-0842

Fax

(248) 366-0065

NPI assigned

May 20, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Alfonso Acosta, MD

Title

President

Phone

(586) 929-0842

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1184881971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250433",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483250433",
            "telephone_number": "586-929-0842",
            "fax_number": "248-366-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7173 ILANAWAY DR",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483242493",
            "telephone_number": "586-929-0842",
            "fax_number": "248-366-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALFONSO ACOSTA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "ALFONSO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-929-0842",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301064369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00193884",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103522994",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "1106335602",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in W Bloomfield, MI
• Providers in W Bloomfield, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.