Active NPI
Armin Mortazavi
- Neurological Surgery Physician
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 4351049080APP22
- Practice address
- 1500 E. Medical Center Drive, 3552 TC
Ann Arbor, MI 48109 - Phone
- (734) 647-7960
- NPI assigned
- Apr 19, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | 4351049080APP22 | MI | Primary |
Addresses
Primary practice location
1500 E. Medical Center Drive, 3552 TC
Ann Arbor, MI 48109
Mailing address
1500 E. Medical Center Drive, 3552 TC
Ann Arbor, MI 48109
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | am3591@georgetown.edu | Direct |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260121000249 | MI | Practitioner - Neurosurgery | 6103204888 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- Georgetown University School of Medicine, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
1609 Barney LN
White Hall, AR 71602-3252
8175 Reliable Pkwy
Chicago, IL 60686-0081
PO Box
Suite 13008
Lansing, MI 48901
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4351049080APP22 | MI | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward W Sparrow Hospital Association | Current | Accepting new patients | |
| Edward W. Sparrow Hospital Association | Neurological Surgery | Current | Accepting new patients |
Locations
8175 Reliable Pkwy
Chicago, IL 60686
1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080
1200 E Michigan Ave
Ste 340
Lansing, MI 48912
Phone (517) 364-5930
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 and National Provider Directory roles.
-
- Adult Health Nurse Practitioner
- Lansing, MI
- NPI 1265220438
-
- Neurological Surgery Physician
- Lansing, MI
- NPI 1689620098
Neurological Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650326400000",
"number": "1700529500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 E. MEDICAL CENTER DRIVE, 3552 TC",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E. MEDICAL CENTER DRIVE, 3552 TC",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48109",
"telephone_number": "734-647-7960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTAZAVI",
"first_name": "ARMIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-19",
"last_updated": "2022-04-19",
"certification_date": "2022-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "MI",
"license": "4351049080APP22",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "am3591@georgetown.edu",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1500 E. Medical Center Drive, 3552 TC",
"city": "Ann Arbor",
"state": "MI",
"country_code": "US",
"postal_code": "48109",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.