Individual provider Active NPI

Gazandra Juarzetta Eiland, M.D.

  • Internal Medicine Physician
  • Ypsilanti, MI
National Provider Identifier
1508875568
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301076369 Issued in MI
Practice address
3145 W Clark Rd
Suite#401
Ypsilanti, MI 48197-1120
Phone
(734) 528-5700
Fax
(734) 528-5701
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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 4301076369 MI Primary

Addresses

Primary practice location

3145 W Clark Rd
Suite#401
Ypsilanti, MI 48197-1120

Mailing address

3145 W Clark Rd
Suite #401
Ypsilanti, MI 48197-1120
Phone (734) 528-5700

Other identifiers 1

IdentifierTypeStateIssuer
4301076369OtherMIPHYSICIAN LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20061129000024 MI Practitioner - Internal Medicine 3173521184 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301076369MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Inpatient Physicians-Michigan, PLLC Internal Medicine Current Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC Internal Medicine CurrentSince Jan 16, 2019 Accepting new patients
Washtenaw Medicine Past Accepting new patients

Locations

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

200 Hemlock St
Tawas City, MI 48763
Phone (989) 362-0153

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3683/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1508875568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 W CLARK RD",
            "address_2": "SUITE #401",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971120",
            "telephone_number": "734-528-5700",
            "fax_number": "734-528-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 W CLARK RD",
            "address_2": "SUITE#401",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971120",
            "telephone_number": "734-528-5700",
            "fax_number": "734-528-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EILAND",
        "first_name": "GAZANDRA",
        "middle_name": "JUARZETTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301076369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "4301076369",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.