Thomas J. Takach, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301402346 Issued in MI

Practice address

1697 Liberty Ave
Cardiothoracic, Vascular, and Endovascular Surgery
Lincoln Park, MI 48146-3517

Phone

(980) 322-3015

NPI assigned

Nov 12, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1245484690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6540 BELLOWS LN # 110",
            "address_2": "FAVROT HALL",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302802",
            "telephone_number": "980-322-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1697 LIBERTY AVE",
            "address_2": "CARDIOTHORACIC, VASCULAR, AND ENDOVASCULAR SURGERY",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463517",
            "telephone_number": "980-322-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKACH",
        "first_name": "THOMAS",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-12",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301402346",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A51118",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.