Individual provider Active NPI

Amelita Anne Maslach, MD

  • Family Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1215126552
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301101920 Issued in MI
Practice address
207 Fletcher St
Ann Arbor, MI 48109-1050
Phone
(734) 764-8320
NPI assigned
Oct 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01063981A IN
Family Medicine Physician 207Q00000X 4301101920 MI Primary

Addresses

Primary practice location

207 Fletcher St
Ann Arbor, MI 48109-1050

Mailing address

207 Fletcher St
Ann Arbor, MI 48109-1050
Phone (734) 764-8320

Other names 1

  • Amelita Anne Calejesan Former name

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
I20131111001266 MI Practitioner - Family Practice 2062698954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pittsburgh School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

207 Fletcher St
Ann Arbor, MI 48109-1050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301101920MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan-Uhs-University Health Ser CurrentSince Aug 6, 2013 Accepting new patients

Locations

207 Fletcher St
Rm 0
Ann Arbor, MI 48109

207 Fletcher St
Ann Arbor, MI 48109
Phone (734) 764-8320

207 Fletcher St
Rm 245G
Ann Arbor, MI 48109
Phone (734) 763-9631

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1215126552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 FLETCHER ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091050",
            "telephone_number": "734-764-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 FLETCHER ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091050",
            "telephone_number": "734-764-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASLACH",
        "first_name": "AMELITA",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01063981A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301101920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMELITA",
            "last_name": "CALEJESAN",
            "middle_name": "ANNE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.