Active NPI
Michael J Occhietti, MD
- Orthopaedic Surgery Physician
- Iron Mountain, MI
National Provider Identifier
1629057187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MO063234
- Practice address
- 1711 South Stephenson Avenue
Suite 100
Iron Mountain, MI 49801 - Phone
- (906) 776-5250
- Fax
- (906) 228-0217
- NPI assigned
- Jan 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MO063234 | MI | Primary |
Addresses
Primary practice location
1711 South Stephenson Avenue
Suite 100
Iron Mountain, MI 49801
Mailing address
1711 South Stephenson Avenue
Suite 100
Iron Mountain, MI 49801
Phone (906) 779-9870
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 383105579 | Other | TAX ID | |
| 32564300 | Medicaid | WI | |
| 4318832 | Medicaid | MI | |
| 300220077 | Other | MI | BLUE CROSS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MO063234 | MI | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563321600000",
"number": "1629057187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 SOUTH STEPHENSON AVENUE",
"address_2": "SUITE 100",
"city": "IRON MOUNTAIN",
"state": "MI",
"postal_code": "49801",
"telephone_number": "906-779-9870",
"fax_number": "906-779-5888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1711 SOUTH STEPHENSON AVENUE",
"address_2": "SUITE 100",
"city": "IRON MOUNTAIN",
"state": "MI",
"postal_code": "49801",
"telephone_number": "906-776-5250",
"fax_number": "906-228-0217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OCCHIETTI",
"first_name": "MICHAEL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-12",
"last_updated": "2019-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MI",
"license": "MO063234",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "383105579",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32564300",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4318832",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "300220077",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Iron Mountain, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.