NPIMap

Organization Active NPI

Maura Bagos, D.O., P.C.

  • Internal Medicine Physician
  • Troy, MI
National Provider Identifier
1891726386
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MB011649 Issued in MI
Legal business name
MAURA BAGOS, D.O., P.C.
Practice address
2701 Troy Center Dr Ste 260
Troy, MI 48084-4741
Phone
(248) 244-8545
Fax
(248) 244-8582
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Authorized official

Name
Maura Lynn Bagos, D.O.NPI 1467483925
Title
Doctor
Phone
(248) 244-8545

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MB011649 MI Primary

Addresses

Primary practice location

2701 Troy Center Dr Ste 260
Troy, MI 48084-4741

Mailing address

2701 Troy Center Dr Ste 260
Troy, MI 48084-4741
Phone (248) 244-8545

Other identifiers 2

IdentifierTypeStateIssuer
4130308MedicaidMI
1156303474OtherMIBCBSM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060801000148 MI Part B Supplier - Clinic/Group Practice 7113930546 Receives reassigned benefits from 2 practitioners
Practice locations: Troy, MI

National Provider Directory

National Provider Directory

Locations

2701 Troy Center Dr
Ste 260
Troy, MI 48084
Phone (248) 244-8545

671 E Big Beaver Rd
Ste 111
Troy, MI 48083
Phone (248) 244-8545

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217548800000",
    "number": "1891726386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 TROY CENTER DR STE 260",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844741",
            "telephone_number": "248-244-8545",
            "fax_number": "248-244-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 TROY CENTER DR STE 260",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844741",
            "telephone_number": "248-244-8545",
            "fax_number": "248-244-8582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURA BAGOS, D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-08-01",
        "status": "A",
        "authorized_official_last_name": "BAGOS",
        "authorized_official_first_name": "MAURA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "248-244-8545",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "MB011649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4130308",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "1156303474",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.