NPIMap

Individual provider Active NPI

Sanjay A Vora, D.O.

  • Internal Medicine Physician
  • Clinton TWP, MI
National Provider Identifier
1467459180
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101013624 Issued in MI
Practice address
15520 19 Mile Rd
Suite 480
Clinton TWP, MI 48038-6333
Phone
(586) 228-1010
Fax
(586) 228-8570
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101013624 MI Primary

Addresses

Primary practice location

15520 19 Mile Rd
Suite 480
Clinton TWP, MI 48038-6333

Mailing address

15520 19 Mile Rd
Suite 480
Clinton TWP, MI 48038-6333
Phone (586) 228-1010

Other identifiers 3

IdentifierTypeStateIssuer
110E07884OtherMIBLUE CROSS/SHIELD GROUP I
4303384MedicaidMI
1155003035OtherMIBLUE CROSS/SHIELD IND PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101118000668 MI Practitioner - Internal Medicine 7810955911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Macomb Internal Medicine PCGroup PAC ID 2961468723, 8 clinicians

Practice addresses (Care Compare)

15520 19 Mile Rd
Suite 480
Clinton TWP, MI 48038-6332
Phone (586) 228-1010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101013624MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Macomb Internal Medicine PC Internal Medicine CurrentSince Jul 1, 2001 Accepting new patients
McLaren Macomb Internal Medicine CurrentSince May 3, 2014 Accepting new patients
McLaren Macomb Past Accepting new patients
MCG Professional Billing L.L.C. Past Accepting new patients

Locations

37399 Garfield Rd
Ste 203
Clinton Twp, MI 48036
Phone (586) 228-2911

36500 S Gratiot Ave
Ste 102
Clinton Twp, MI 48035
Phone (586) 790-9003

37399 Garfield Rd
Ste 106
Clinton Twp, MI 48036
Phone (586) 226-3500

15520 19 Mile Rd
Ste 480
Clinton Twp, MI 48038
Phone (313) 228-1010

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

65 Macomb Pl
Mount Clemens, MI 48043
Phone (810) 465-9630

Interoperability endpoints

  • Direct secure messaging: sanjay.vora.1@31117.direct.athenahealth.com

Organizations & group practices 4

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 6

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1467459180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15520 19 MILE RD",
            "address_2": "SUITE 480",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386333",
            "telephone_number": "586-228-1010",
            "fax_number": "586-228-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15520 19 MILE RD",
            "address_2": "SUITE 480",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386333",
            "telephone_number": "586-228-1010",
            "fax_number": "586-228-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VORA",
        "first_name": "SANJAY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101013624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD GROUP I",
            "identifier": "110E07884",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4303384",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD IND PIN",
            "identifier": "1155003035",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

Verify at the official NPI Registry.