Luis C. Gago, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4301076027 Issued in MI

Practice address

2350 E Stadium Blvd
Suite 10
Ann Arbor, MI 48104-4889

Phone

(877) 852-8463

Fax

(734) 994-6283

NPI assigned

Dec 8, 2006

Last updated

Sep 20, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Specialty

Ophthalmology

Education

Wayne State University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid Michigan Eye Care Center PCGroup PAC ID 4486566098, 31 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lgago37407@direct.trinity-health.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mid Michigan Eye Care Center, PC

  dba Specialty Eye Institute

  • Ophthalmology Physician
  • Jackson, MI
  • NPI 1649275041
  Medicare reassignment Care Compare group NPD
• Surgical Services of Michigan, LLC

  dba Blake Woods Medical Park

  • Ambulatory Surgical Clinic/Center
  • Jackson, MI
  • NPI 1588631832
  Medicare reassignment
• DRS. Ravin, Birndorf & Ravin, Inc.

  dba Specialty Eye Institute

  • Ophthalmology Physician
  • Toledo, OH
  • NPI 1316043110
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1386704781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W NORTH ST STE 104",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023196",
            "telephone_number": "877-852-8463",
            "fax_number": "571-817-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 E STADIUM BLVD",
            "address_2": "SUITE 10",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044889",
            "telephone_number": "877-852-8463",
            "fax_number": "734-994-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGO",
        "first_name": "LUIS",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301076027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386704781",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "180H149970",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "LG076027",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE CROSS",
            "identifier": "180H262240",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "467549710",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "LG076027",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany Jane Gaffka, PHD
• Diane Sue Gaffney, NP
• Stephanie Diane Gage, CRNA
• Paul Gagnet, MD
• Leah Susan Gagnon, MA, ATC
• Maria Lynne Gahry, DNP, FNP-BC
• Elissa Gaies, MD
• Jonathan Read Gaillard, MD
• Kathy Ann Gaines, P.T.
• Lauren Michelle Gaines, PA-C

• Ophthalmology Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.