Individual provider Active NPI

Masakatsu Nanamori, M.D.

  • Anesthesiology Physician
  • Detroit, MI
National Provider Identifier
1760656250
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301102510 Issued in MI
Practice address
1 Ford PL
Detroit, MI 48202-3450
Phone
(313) 352-6849
NPI assigned
Apr 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X C194646 CA
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 4301102510 MI
Anesthesiology Physician 207L00000X 4301102510 MI Primary

Addresses

Primary practice location

1 Ford PL
Detroit, MI 48202-3450

Mailing address

26471 Glenwood Dr
Novi, MI 48374-2140
Phone (708) 856-9382

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130830000138 MI Practitioner - AnesthesiologyPractitioner - Critical Care (Intensivists) 8224281233 Reassigns benefits to 1 organization
I20240531002243 CA Practitioner - Anesthesiology 8224281233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

2000 Mowry Ave
Fremont, CA 94538-1716
Phone (510) 797-1111

Hospital & facility affiliations

  • Washington Hospital Hospital, Fremont, CA, CCN 050195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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

State licenses

LicenseStateTypeSpecialty
C194646CAMDAnesthesiology Physician
4301102510MIMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford West Bloomfield Hospital Anesthesiology CurrentSince Oct 1, 2022 Accepting new patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients
Henry Ford West Bloomfield Hospital CurrentSince Oct 1, 2022 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince May 20, 2024 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince May 20, 2024 Accepting new patients
Henry Ford Macomb Hospital Corporation Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

350 Marine Pkwy
Ste 100
Redwood City, CA 94065
Phone (510) 406-9731

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1760656250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26471 GLENWOOD DR",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483742140",
            "telephone_number": "708-856-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FORD PL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-352-6849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANAMORI",
        "first_name": "MASAKATSU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C194646",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MI",
            "license": "4301102510",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301102510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.