Individual provider Active NPI

Emmanuel N Papasifakis, DO

  • Cardiovascular Disease Physician
  • Garden City, MI
National Provider Identifier
1457386146
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
EP006579 Issued in MI
Practice address
30626 Ford Rd
Garden City, MI 48135-1870
Phone
(734) 261-9211
Fax
(734) 261-8537
NPI assigned
Jul 11, 2006
Last updated
May 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X EP006579 MI Primary

Addresses

Primary practice location

30626 Ford Rd
Garden City, MI 48135-1870

Mailing address

30626 Ford Rd
Garden City, MI 48135-1870
Phone (734) 261-9211

Other identifiers 1

IdentifierTypeStateIssuer
4591486MedicaidMI

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
EP006579MIMDCardiovascular Disease Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306454400000",
    "number": "1457386146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30626 FORD RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481351870",
            "telephone_number": "734-261-9211",
            "fax_number": "734-261-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30626 FORD RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481351870",
            "telephone_number": "734-261-9211",
            "fax_number": "734-261-8537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPASIFAKIS",
        "first_name": "EMMANUEL",
        "middle_name": "N",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "EP006579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4591486",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; 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.