Active NPI
Wallace A Arneson Jr., MD
- Surgery Physician
- Ypsilanti, MI
National Provider Identifier
1497791156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 4301036634
- Practice address
- 5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633 - Phone
- (734) 712-8150
- Fax
- (734) 712-8151
- NPI assigned
- Jun 21, 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301036634 | MI | Primary |
Addresses
Primary practice location
5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633
Mailing address
5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633
Phone (734) 712-8150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4146890-10 | 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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michigan Multispecialty Physicians, P.C. | Surgery | Past | Accepting new patients |
| Iha Health Services Corporation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Plymouth, MI
- NPI 1912184201
-
- Critical Care Medicine (Internal Medicine) Physician
- Ypsilanti, MI
- NPI 1912941337
Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301270400000",
"number": "1497791156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5325 ELLIOTT DR",
"address_2": "SUITE 104",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481978633",
"telephone_number": "734-712-8150",
"fax_number": "734-712-8151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5325 ELLIOTT DR",
"address_2": "SUITE 104",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481978633",
"telephone_number": "734-712-8150",
"fax_number": "734-712-8151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARNESON",
"first_name": "WALLACE",
"middle_name": "A",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2011-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301036634",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4146890-10",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.