Organization Active NPI

Infectious Diseases Associates, P.C.

  • Exclusive Provider Organization
  • Ypsilanti, MI
National Provider Identifier
1730135294
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
029166 Issued in MI
Legal business name
INFECTIOUS DISEASES ASSOCIATES, P.C.
Practice address
5333 McAuley Dr
R3106
Ypsilanti, MI 48197-1014
Phone
(734) 712-8600
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Authorized official

Name
Dr. Michael Otto, M.D.
Title
President
Phone
(734) 712-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 029166 MI Primary

Addresses

Primary practice location

5333 McAuley Dr
R3106
Ypsilanti, MI 48197-1014

Mailing address

5333 McAuley Dr
R3106
Ypsilanti, MI 48197-1014
Phone (734) 712-8600

Other identifiers 1

IdentifierTypeStateIssuer
1046837MedicaidMI

National Provider Directory

National Provider Directory

Locations

5333 McAuley Dr
Rm 3106
Ypsilanti, MI 48197
Phone (313) 434-4333

5333 McAuley Dr
#R3106
Ypsilanti, MI 48197
Phone (734) 663-7731

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278460800000",
    "number": "1730135294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR",
            "address_2": "R3106",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971014",
            "telephone_number": "734-712-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR",
            "address_2": "R3106",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971014",
            "telephone_number": "734-712-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFECTIOUS DISEASES ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2010-07-07",
        "status": "A",
        "authorized_official_last_name": "OTTO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-712-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MI",
            "license": "029166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1046837",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.