Individual provider Active NPI

Mark Stephen Gulyas, D.C.

  • Chiropractor
  • Clinton TWP, MI
National Provider Identifier
1548315534
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301004905 Issued in MI
Practice address
33143 S Gratiot Ave
Clinton TWP, MI 48035-4037
Phone
(586) 791-4880
NPI assigned
Jan 23, 2007
Last updated
Feb 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301004905 MI Primary

Addresses

Primary practice location

33143 S Gratiot Ave
Clinton TWP, MI 48035-4037

Mailing address

33143 S Gratiot Ave
Clinton TWP, MI 48035-4037
Phone (586) 791-4880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090212000676 MI Practitioner - Chiropractic 5193880821 Practice locations: Shelby TWP, MI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

33143 Gratiot Ave
Clinton Township, MI 48035-4037

54908 Pelican LN
Shelby TWP, MI 48315-1384
Phone (586) 791-4880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1548315534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33143 S GRATIOT AVE",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354037",
            "telephone_number": "586-791-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33143 S GRATIOT AVE",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354037",
            "telephone_number": "586-791-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULYAS",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.