Individual provider Active NPI

Mary B Kaplan, MD

  • Family Medicine Physician
  • Warren, MI
National Provider Identifier
1861477614
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301039793 Issued in MI
Practice address
30117 Schoenherr Rd
Suite 100
Warren, MI 48088-6851
Phone
(586) 751-8844
Fax
(586) 751-8596
NPI assigned
Dec 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301039793 MI Primary

Addresses

Primary practice location

30117 Schoenherr Rd
Suite 100
Warren, MI 48088-6851

Mailing address

30117 Schoenherr Rd
Suite 100
Warren, MI 48088-6851
Phone (586) 751-8844

Other identifiers 1

IdentifierTypeStateIssuer
4560004MedicaidMI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160218001869 MI Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 5193619724

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301039793MIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861477614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30117 SCHOENHERR RD",
            "address_2": "SUITE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886851",
            "telephone_number": "586-751-8844",
            "fax_number": "586-751-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30117 SCHOENHERR RD",
            "address_2": "SUITE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886851",
            "telephone_number": "586-751-8844",
            "fax_number": "586-751-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPLAN",
        "first_name": "MARY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301039793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4560004",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.