Marino Moutafis, REG. AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

5401000071 Issued in MI

Practice address

7115 Orchard Lake Rd Ste 410
West Bloomfield, MI 48322-3655

Phone

(248) 432-2846

Fax

(248) 757-2172

NPI assigned

Feb 24, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Metro Detroit Acupuncture, PLLC

  • Acupuncturist
  • West Bloomfield, MI
  • NPI 1922773852
  NPD

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1366867624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7115 ORCHARD LAKE RD STE 410",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223655",
            "telephone_number": "248-432-2846",
            "fax_number": "248-757-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7115 ORCHARD LAKE RD STE 410",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223655",
            "telephone_number": "248-432-2846",
            "fax_number": "248-757-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTAFIS",
        "first_name": "MARINO",
        "credential": "REG. AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-24",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MI",
            "license": "5401000071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Acupuncturist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.