NPIMap

Organization Active NPI

Caro Health Plaza PLC

  • Rural Health Clinic/Center
  • Caro, MI
National Provider Identifier
1689022469
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CARO HEALTH PLAZA PLC
Practice address
1525 W Caro Rd
Caro, MI 48723-9686
Phone
(989) 672-2100
Fax
(989) 672-2120
NPI assigned
Jun 2, 2016
Last updated
Aug 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Authorized official

Name
Naveed Mahfoooz, MD
Title
Owner
Phone
(989) 672-2100

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1525 W Caro Rd
Caro, MI 48723-9686

Mailing address

1525 W Caro Rd
Caro, MI 48723-9686
Phone (989) 672-2100

Other identifiers 2

IdentifierTypeStateIssuer
1659326395MedicaidMI
1689022469MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060111000548 MI Part B Supplier - Clinic/Group Practice 0648293068 Receives reassigned benefits from 18 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay City, MI; Caro, MI
O20140722002159 MI Part A Provider - Rural Health Clinic 0648293068 1 other NPI on this enrollment
Practice locations: Caro, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689022469. Details of each certification follow.

Rural health clinic certification: CCN 238932

Legal name
CARO HEALTH PLAZA PLC
Doing business as
CARO HEALTH PLAZA PLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 8, 2015
Last certification
Jan 11, 2022
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Jul 20, 2005 in MI
Enrollment address
1525 W Caro Rd
Caro, MI 48723-9686

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

193 W Huron Ave
Vassar, MI 48768
Phone (989) 823-3466

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Hamza Sikander Individual W-2 Managing Employee Jan 1, 2000
Naveed Mahfooz Individual 5% Or Greater Direct Ownership Interest Jan 1, 2005 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1689022469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 W CARO RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487239686",
            "telephone_number": "989-672-2100",
            "fax_number": "989-672-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 W CARO RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487239686",
            "telephone_number": "989-672-2100",
            "fax_number": "989-672-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARO HEALTH PLAZA PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-02",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "MAHFOOOZ",
        "authorized_official_first_name": "NAVEED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-672-2100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659326395",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689022469",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caro, MI

Sources for this page

Verify at the official NPI Registry.