Prizm Anesthesia Associates PLLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

4301056069 Issued in IL

Legal business name

PRIZM ANESTHESIA ASSOCIATES PLLC

Practice address

6200 N Haggerty Rd
Canton, MI 48187-3605

Phone

(734) 526-8860

NPI assigned

May 9, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Rosenberg, MD

Title

Authorized Official

Phone

(224) 231-4363

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1679929699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33661",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482325661",
            "telephone_number": "224-231-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 N HAGGERTY RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873605",
            "telephone_number": "734-526-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIZM ANESTHESIA ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "224-231-4363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "5101016547",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IL",
            "license": "4301056069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Provider Service Organization

• Pain Medicine Physician in Canton, MI
• Providers in Canton, MI by specialty
• Pain Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.