NPIMap

Organization Active NPI

John M Cilluffo MD PLC

  • Neurological Surgery Physician
  • Petoskey, MI
National Provider Identifier
1740519818
Registry record updated Dec 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4301044523 Issued in MI
Legal business name
JOHN M CILLUFFO MD PLC
Practice address
2202 Mitchell Park Drive
Petoskey, MI 49770-2070
Phone
(231) 348-2811
NPI assigned
Dec 18, 2009
Last updated
Dec 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2009

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

Authorized official

Name
John M Cilluffo, M.D.
Title
President
Phone
(231) 348-2811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 4301044523 MI Primary

Addresses

Primary practice location

2202 Mitchell Park Drive
Petoskey, MI 49770-2070

Mailing address

PO Box 2070
Petoskey, MI 49770-2070
Phone (231) 348-2811

Other identifiers 2

IdentifierTypeStateIssuer
1402410051OtherMIBCBS OF MICHIGAN
1777018-10MedicaidMI

National Provider Directory

National Provider Directory

Locations

1063 US Highway 23 N
Alpena, MI 49707
Phone (517) 358-6824

2202 Mitchell Park Dr
Petoskey, MI 49770
Phone (231) 348-2811

1221 Sixth St
Ste 308
Traverse City, MI 49684
Phone (231) 348-2811

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261094400000",
    "number": "1740519818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2070",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702070",
            "telephone_number": "231-348-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 MITCHELL PARK DRIVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702070",
            "telephone_number": "231-348-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M CILLUFFO MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-18",
        "last_updated": "2009-12-18",
        "status": "A",
        "authorized_official_last_name": "CILLUFFO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-348-2811",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301044523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "1402410051",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1777018-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; 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.