Madhura Mansabdar, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301070805 Issued in MI

Practice address

411 W Broadway St
Suite a
Mt Pleasant, MI 48858-2402

Phone

(989) 772-9523

Fax

(989) 772-9052

NPI assigned

Jun 8, 2006

Last updated

Jun 26, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Gratiot Medical Specialists, P.C.

  • Internal Medicine Physician
  • Alma, MI
  • NPI 1417039611
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1639119373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W BROADWAY ST",
            "address_2": "SUITE A",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582446",
            "telephone_number": "989-772-9523",
            "fax_number": "989-772-9052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W BROADWAY ST",
            "address_2": "SUITE A",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582402",
            "telephone_number": "989-772-9523",
            "fax_number": "989-772-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSABDAR",
        "first_name": "MADHURA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301070805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP COMMERCIAL",
            "identifier": "200000008878",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "1103710561",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4565207-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS",
            "identifier": "0988830",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4270238-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "1007076",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Malone, LLPC
• Kathleen Maness, PT
• Cari Maniteau, MA, LPC, CAADC
• Angel Manjarrez, PH.D., LPC
• Caitlin Mann
• Alexis Sydney Marioth
• Mark D Young DPM
• Haleigh Elizabeth Marshall
• Kari Ann Martin, MSPT
• Kathleen Martin, R.N., L.M.T.

• Internal Medicine Physician in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.