Individual provider Active NPI

Calvin J. Maestro Jr., M.D.

  • Family Medicine Physician
  • Oscoda, MI
National Provider Identifier
1508184425
Registry record updated May 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301071699 Issued in MI
Practice address
9100B Wyoming St
Oscoda, MI 48750
Phone
(989) 254-2103
NPI assigned
May 17, 2010
Last updated
May 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301071699 MI Primary

Addresses

Primary practice location

9100B Wyoming St
Oscoda, MI 48750

Mailing address

9100B Wyoming St
Oscoda, MI 48750-2321
Phone (989) 254-2103

Other practice location 1

177 N Barlow Rd
Harrisville, MI 48740-9607
Phone (989) 736-8157

Other practice location 2

3355 Eagle Park Dr NE Ste 103
Grand Rapids, MI 49525
Phone (616) 942-7400

Other practice location 3

3355 Eagle Park Dr NE Ste 103
Grand Rapids, MI 49525
Phone (616) 942-7400

Other practice location 4

3355 Eagle Park Dr NE Ste 103
Grand Rapids, MI 49525
Phone (616) 942-7400

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

OrganizationSpecialtyStatusNew patients
Alcona Citizens for Health, Inc. Current Accepting new patients
Iah of Michigan, PLLC Family Medicine PastSince Mar 1, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: calvinmaestro-mmacfh@direct.medalliesmail.com

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, 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": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1508184425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100B WYOMING ST",
            "city": "OSCODA",
            "state": "MI",
            "postal_code": "487502321",
            "telephone_number": "989-254-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100B WYOMING ST",
            "city": "OSCODA",
            "state": "MI",
            "postal_code": "48750",
            "telephone_number": "989-254-2103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 N Barlow Rd",
            "address_purpose": "LOCATION",
            "city": "Harrisville",
            "state": "MI",
            "postal_code": "487409607",
            "country_code": "US",
            "telephone_number": "989-736-8157",
            "fax_number": "989-358-3762",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3355 Eagle Park Dr NE Ste 103",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "49525",
            "country_code": "US",
            "telephone_number": "616-942-7400",
            "fax_number": "616-942-7405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3355 Eagle Park Dr NE Ste 103",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "49525",
            "country_code": "US",
            "telephone_number": "616-942-7400",
            "fax_number": "616-942-7405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3355 Eagle Park Dr NE Ste 103",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "49525",
            "country_code": "US",
            "telephone_number": "616-942-7400",
            "fax_number": "616-942-7405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAESTRO",
        "first_name": "CALVIN",
        "middle_name": "J.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-17",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301071699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oscoda, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.