Individual provider Active NPI

Maria Vlachaki, M.D.

  • Radiation Oncology Physician
  • Detroit, MI
National Provider Identifier
1366443137
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
4301087410 Issued in MI
Practice address
4100 John R St
Detroit, MI 48201-2013
Phone
(313) 745-9191
NPI assigned
Aug 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 231527 NY
Radiation Oncology Physician 2085R0001X 4301087410 MI Primary

Addresses

Primary practice location

4100 John R St
Detroit, MI 48201-2013

Mailing address

3800 Woodward Ave
Suite 702
Detroit, MI 48201-2061

Other identifiers 2

IdentifierTypeStateIssuer
02547015MedicaidNY
4870830MedicaidMI

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
I20060707000315 MI Practitioner - Radiation Oncology 9234120601 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiation Oncology Specialists PCGroup PAC ID 1355378753, 6 clinicians
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians
North Macomb MRT Center LLCGroup PAC ID 6901973759, 7 clinicians

Practice addresses (Care Compare)

11800 E 12 Mile Rd
Radiation Oncology Spec PC
Warren, MI 48093-3472
Phone (586) 573-5000

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

1901 Star Batt Dr
Rochester Hills, MI 48309-3767
Phone (248) 844-4000

19229 Mack Ave
Suite 10
Grosse Pointe Woods, MI 48236-2857
Phone (313) 647-3100

Hospital & facility affiliations

  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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
4301087410MIMDRadiation Oncology Physician
231527NYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System North Macomb MRT Center LLC Radiation Oncology CurrentSince Apr 15, 2014 Accepting new patients
Henry Ford Health System Radiation Oncology Specialists PC Radiation Oncology CurrentSince Apr 15, 2014 Accepting new patients
University Physician Group Past Accepting new patients
New York University Past Accepting new patients

Locations

2348 Momentum Pl
Chicago, IL 60689

19229 Mack Ave
Ste 10
Grosse Pointe Woods, MI 48236
Phone (313) 647-3000

17900 23 Mile Rd
Ste 103
Macomb, MI 48044
Phone (586) 753-0927

1901 Star Batt Dr
Rochester Hills, MI 48309
Phone (248) 650-4580

Interoperability endpoints

  • Direct secure messaging: mvlachaki1156687@direct.hfhs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366443137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVE",
            "address_2": "SUITE 702",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "313-745-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLACHAKI",
        "first_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "231527",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "4301087410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02547015",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4870830",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.