Individual provider Active NPI

Craig B Mizes, M.D.

  • Surgery Physician
  • Cass City, MI
National Provider Identifier
1356370803
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
E5584 Issued in AR
Practice address
6190 Hospital Dr
Cass City, MI 48726-1072
Phone
(989) 872-5582
NPI assigned
Jun 30, 2006
Last updated
Mar 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X E5584 AR Primary

Addresses

Primary practice location

6190 Hospital Dr
Cass City, MI 48726-1072

Mailing address

6190 Hospital Dr
Cass City, MI 48726-1072
Phone (989) 872-5582

Other identifiers 1

IdentifierTypeStateIssuer
175019001MedicaidAR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cmizes97076@direct.covenanthealthcare.com
Direct Messaging Address cmizes97076@direct.covenanthealthcare.com

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
I20210120000321 MI Practitioner - General Surgery 0648251587 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E5584ARMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hills & Dales General Hospital, Inc. CurrentSince Jan 20, 2021 Accepting new patients
Hills & Dales General Hospital, Inc. CurrentSince Jan 20, 2021 Accepting new patients
St Marys Physician Services, LLC Past Accepting new patients
Craig B. Mizes, M.D., P.a. Surgery PastSince May 16, 2006 Accepting new patients

Locations

4675 Hill St
Cass City, MI 48726
Phone (989) 872-2121

4675 Hill St
Ste B
Cass City, MI 48726
Phone (989) 912-6112

6190 Hospital Dr
Cass City, MI 48726
Phone (989) 872-8303

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1356370803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6190 HOSPITAL DR",
            "city": "CASS CITY",
            "state": "MI",
            "postal_code": "487261072",
            "telephone_number": "989-872-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6190 HOSPITAL DR",
            "city": "CASS CITY",
            "state": "MI",
            "postal_code": "487261072",
            "telephone_number": "989-872-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZES",
        "first_name": "CRAIG",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E5584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175019001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmizes97076@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "6190 Hospital Dr",
            "city": "Cass City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "487261072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmizes97076@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "4675 Hill St",
            "city": "Cass City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "487261099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cass City, MI

Sources for this page

Verify at the official NPI Registry.