Individual provider Active NPI

Marisa Martinez-Swanson, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Ann Arbor, MI
National Provider Identifier
1376956680
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4301105444 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone
(734) 763-7919
NPI assigned
Jun 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301105444 MI
Student in an Organized Health Care Education/Training Program 390200000X 4301105444 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109

Mailing address

1500 E Medical Center Dr
Ann Arbor, MI 48109-5305
Phone (734) 763-7919

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
I20180809001181 MI Practitioner - Emergency Medicine 2264650100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wayne State University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epmg of Michigan PCGroup PAC ID 4789596339, 108 clinicians

Practice addresses (Care Compare)

5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301105444MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Physicians Medical Group of Michigan, PC Emergency Medicine CurrentSince May 1, 2021 Accepting new patients
Epmg of Michigan, P.C. Emergency Medicine CurrentSince Sep 15, 2018 Accepting new patients
Hospitalist Physicians Medical Group of Michigan, PC Emergency Medicine CurrentSince May 1, 2021 Accepting new patients

Locations

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Organizations & group practices 3

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 2

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": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1376956680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095305",
            "telephone_number": "734-763-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48109",
            "telephone_number": "734-763-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ-SWANSON",
        "first_name": "MARISA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301105444",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301105444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.