Individual provider Active NPI

Cary A Gottlieb, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Escanaba, MI
National Provider Identifier
1649242124
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301406387 Issued in MI
Practice address
3401 Ludington St
Escanaba, MI 49829-1300
Phone
(906) 226-9127
NPI assigned
Feb 7, 2006
Last updated
Oct 18, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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 4301406387 MI Primary

Addresses

Primary practice location

3401 Ludington St
Escanaba, MI 49829-1300

Mailing address

2837 US Highway 41 W
Marquette, MI 49855-2252
Phone (906) 225-3964

Other identifiers 2

IdentifierTypeStateIssuer
4194270MedicaidMI
220520070OtherMIBLUE CROSS BLUE SHIELD MI

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
I20070906000099 MI Practitioner - Pathology 1254424351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Wayne State University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis HospitalGroup PAC ID 5991604753, 85 clinicians

Practice addresses (Care Compare)

3401 Ludington St
Escanaba, MI 49829-1300
Phone (906) 786-5707

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301406387MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Hospital Anatomic Pathology & Clinical Pathology CurrentSince Oct 21, 2015 Accepting new patients
St Francis Hospital Anatomic Pathology & Clinical Pathology CurrentSince Oct 21, 2015 Accepting new patients

Locations

3401 Ludington St
Escanaba, MI 49829
Phone (906) 786-3311

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1649242124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 US HIGHWAY 41 W",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552252",
            "telephone_number": "906-225-3964",
            "fax_number": "906-226-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498291300",
            "telephone_number": "906-226-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "CARY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301406387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4194270",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "220520070",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

Verify at the official NPI Registry.