Active NPI
Alfredo Balarezo, MD
- Neurological Surgery Physician
- Taylor, MI
National Provider Identifier
1386661015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- AB034772
- Practice address
- 20600 Eureka Rd
Ste 801
Taylor, MI 48180 - Phone
- (734) 285-7880
- Fax
- (734) 285-2020
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | AB034772 | MI | Primary |
Addresses
Primary practice location
20600 Eureka Rd
Ste 801
Taylor, MI 48180
Mailing address
20600 Eureka Rd
Ste 801
Taylor, MI 48180
Phone (734) 285-7880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2732271 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AB034772 | MI | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268179200000",
"number": "1386661015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20600 EUREKA RD",
"address_2": "STE 801",
"city": "TAYLOR",
"state": "MI",
"postal_code": "48180",
"telephone_number": "734-285-7880",
"fax_number": "734-285-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20600 EUREKA RD",
"address_2": "STE 801",
"city": "TAYLOR",
"state": "MI",
"postal_code": "48180",
"telephone_number": "734-285-7880",
"fax_number": "734-285-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALAREZO",
"first_name": "ALFREDO",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2010-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "MI",
"license": "AB034772",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2732271",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Taylor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.