Luis Gaspar Maduro Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12074 Issued in PR

Practice address

18161 W 13 Mile Rd
Southfield, MI 48076

Phone

(248) 480-4183

Fax

(248) 792-2631

NPI assigned

Apr 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, MI2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: luis.madurofigueroa@4048.securemail.prognocis.com

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.

• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375
  Medicare reassignment NPD
• Round Valley Indian Health Center, Inc.

  • Clinic/Center
  • Covelo, CA
  • NPI 1669532750

  Family Medicine

  Medicare reassignment NPD
• Integrative Functional Medicine Wellness

  • Family Medicine Physician
  • Lansing, MI
  • NPI 1831953496
  NPD Authorized official
• Laurel Health Care Company of Mt Pleasant

  • Nursing Facility/Intermediate Care Facility
  • Mt Pleasant, MI
  • NPI 1649225335
  NPD (past)
• The Laurels of Carson City, LLC

  • Skilled Nursing Facility
  • Carson City, MI
  • NPI 1417171844
  NPD (past)
• Round Valley Indian Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Covelo, CA
  • NPI 1114136066
  NPD (past)
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1881813079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18161 W 13 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761113",
            "telephone_number": "248-480-4183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18161 W 13 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48076",
            "telephone_number": "248-480-4183",
            "fax_number": "248-792-2631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7649 W Vernor Hwy",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482091513",
            "country_code": "US",
            "telephone_number": "313-841-0395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "808 Livernois St",
            "address_purpose": "LOCATION",
            "city": "Ferndale",
            "state": "MI",
            "postal_code": "482202309",
            "country_code": "US",
            "telephone_number": "248-439-0557",
            "fax_number": "248-439-0558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADURO",
        "first_name": "LUIS",
        "middle_name": "GASPAR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "12074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Madgy
• Arti Madhavan, MD
• Santhosh Madhavan, MD
• Norma Dozier Madison, PSY.D.
• Taqueisha Madison
• Maecenas Health Systems PC
• Joy Anne Maedel
• Alvaro Magalhaes, MD
• Donald Jay Magder, MA, LLP
• Kyana Magee-Houston, LPC

• Family Medicine Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.