Individual provider Active NPI

Christina R Yavarow, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Kalamazoo, MI
National Provider Identifier
1619964301
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301079389 Issued in MI
Practice address
1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone
(269) 226-7000
NPI assigned
Sep 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301079389 MI Primary

Addresses

Primary practice location

1521 Gull Rd
Kalamazoo, MI 49048-1640

Mailing address

6810 Reliable Pkwy
Chicago, IL 60686-0001
Phone (269) 226-7000

Other identifiers 1

IdentifierTypeStateIssuer
1619964301MedicaidMI

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
I20100526000631 MI Practitioner - Pathology 5193854370 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Minnesota Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patholgy Services of Kalamazoo PCGroup PAC ID 0143123034, 13 clinicians

Practice addresses (Care Compare)

601 John St
Kalamazoo, MI 49007-5341
Phone (269) 341-7654

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301079389MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Jul 1, 2014 Accepting new patients
Patholgy Services of Kalamazoo, PC Anatomic Pathology & Clinical Pathology CurrentSince Sep 6, 2011 Accepting new patients
Diagnostic Pathology Services of Southwest Michigan PC Anatomic Pathology & Clinical Pathology CurrentSince Jul 27, 2018 Accepting new patients
Southwest Michigan Pathology Services, PC Anatomic Pathology & Clinical Pathology CurrentSince Nov 20, 2018 Accepting new patients
Pathology Services of Southwestern Michigan, PC Anatomic Pathology & Clinical Pathology Current Accepting new patients

Locations

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 5

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 4

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1619964301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 RELIABLE PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606860001",
            "telephone_number": "269-226-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481640",
            "telephone_number": "269-226-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAVAROW",
        "first_name": "CHRISTINA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301079389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619964301",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.