Individual provider Active NPI

Philip Andrew Cornell Saragoza, M.D.

  • Forensic Psychiatry Physician
  • Ann Arbor, MI
National Provider Identifier
1730202599
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
4301085725 Issued in MI
Practice address
2395 Oak Valley Dr Ste 100
Ann Arbor, MI 48103-9118
Phone
(734) 995-5181
Fax
(734) 995-9011
NPI assigned
Apr 9, 2007
Last updated
Feb 10, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 4301085725 MI Primary
Psychiatry Physician 2084P0800X 4301085725 MI

Addresses

Primary practice location

2395 Oak Valley Dr Ste 100
Ann Arbor, MI 48103-9118

Mailing address

2395 Oak Valley Dr Ste 100
Ann Arbor, MI 48103-9118
Phone (734) 995-5181

Other identifiers 1

IdentifierTypeStateIssuer
0942132OtherMIBCBS PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 4, 2016 through May 4, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1730202599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2395 OAK VALLEY DR STE 100",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039118",
            "telephone_number": "734-995-5181",
            "fax_number": "734-995-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 OAK VALLEY DR STE 100",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039118",
            "telephone_number": "734-995-5181",
            "fax_number": "734-995-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARAGOZA",
        "first_name": "PHILIP",
        "middle_name": "ANDREW CORNELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "MI",
            "license": "4301085725",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301085725",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "0942132",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.