Jose Maldonado-Vazquez, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

069529 Issued in MI

Practice address

104 W 6TH St
Clare, MI 48617-1409

Phone

(989) 386-9951

NPI assigned

Jun 8, 2006

Sex

Male

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

State licenses

Practice roles

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.

• Epmg of Michigan, P.C.

  • Emergency Medicine Physician
  • Livonia, MI
  • NPI 1386688992
  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": "1283212800000",
    "number": "1669413282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GREEN RD",
            "address_2": "SUITE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 6TH ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171409",
            "telephone_number": "989-386-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO-VAZQUEZ",
        "first_name": "JOSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "069529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4081947",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "JM069529",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4081938",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4081929",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4091934",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4091943",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cherie Lalone, LPC
• Nicholas Latuszek, DPT
• Daniel Leppek, PT
• Brianna Rose Lybeer, MA CCC-SLP
• Magnum Health and Rehab of Clare LLC
• Adnan Anwar Malik, M.D.
• Cedric B Masa, M.D.
• Tana Lyn Mashue Spicer
• Kelly Marie Mathison
• McConnell Physical Therapy LLC

• Emergency Medical Services (Emergency Medicine) Physician in Clare, MI
• Providers in Clare, MI by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.