Active NPI
Advanced Gynecology Specialist of Marshall PLLC
- Obstetrics & Gynecology Physician
- Marshall, MI
National Provider Identifier
1376961672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 4301084659
- Legal business name
- ADVANCED GYNECOLOGY SPECIALIST OF MARSHALL PLLC
- Practice address
- 139 West Mansion Street
Marshall, MI 49068-1167 - Phone
- (269) 248-6090
- Fax
- (269) 248-6095
- NPI assigned
- Apr 3, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Sara Gurzynski
- Title
- Office Manager
- Phone
- (269) 248-6090
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 4301084659 | MI | Primary |
Addresses
Primary practice location
139 West Mansion Street
Marshall, MI 49068-1167
Mailing address
139 West Mansion Street
Marshall, MI 49068-1167
Phone (269) 248-6090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140422002201 | MI | Part B Supplier - Clinic/Group Practice | 1557593712 |
Receives reassigned benefits from 4 practitioners Practice locations: Marshall, MI |
National Provider Directory
National Provider DirectoryPractitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Marshall, MI
- NPI 1629288394
MI, Obstetrics & Gynecology
-
- Women's Health Nurse Practitioner
- Richland, MI
- NPI 1407652431
MI
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396483200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1396483200000",
"number": "1376961672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 WEST MANSION STREET",
"city": "MARSHALL",
"state": "MI",
"postal_code": "490681167",
"telephone_number": "269-248-6090",
"fax_number": "269-248-6095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 WEST MANSION STREET",
"city": "MARSHALL",
"state": "MI",
"postal_code": "490681167",
"telephone_number": "269-248-6090",
"fax_number": "269-248-6095"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED GYNECOLOGY SPECIALIST OF MARSHALL PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-04-03",
"last_updated": "2014-04-03",
"status": "A",
"authorized_official_last_name": "GURZYNSKI",
"authorized_official_first_name": "SARA",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "269-248-6090",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": "MI",
"license": "4301084659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marshall, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.