Organization Active NPI

Plasencia Family Medicine PLLC

  • Family Medicine Physician
  • Saginaw, MI
National Provider Identifier
1982642898
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PLASENCIA FAMILY MEDICINE PLLC
Practice address
4705 Towne Ctr
Suite 202
Saginaw, MI 48604-2818
Phone
(989) 791-3401
Fax
(989) 791-3466
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Authorized official

Name
Jorge Plasencia, M.D.NPI 1760466346
Title
Owner
Phone
(989) 791-3401

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4705 Towne Ctr
Suite 202
Saginaw, MI 48604-2818

Mailing address

4705 Towne Centre Rd
Suite 202
Saginaw, MI 48604-2818
Phone (989) 791-3401

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jplasencia1218@direct.covenanthealthcare.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050808000972 MI Part B Supplier - Clinic/Group Practice 0446289623 Receives reassigned benefits from 2 practitioners
Practice locations: Saginaw, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D1043909Plasencia Family Medicine PLLC4705 Towne Centre, Saginaw, MI 48604Certificate of waiverAug 4, 2027

National Provider Directory

National Provider Directory

Locations

4705 Towne Centre Rd
Ste 202
Saginaw, MI 48604
Phone (989) 791-3401

Interoperability endpoints

  • Direct secure messaging: jplasencia1218@direct.covenanthealthcare.com

Practitioners & affiliated clinicians

Practitioners 2

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": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1982642898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 TOWNE CENTRE RD",
            "address_2": "SUITE 202",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042818",
            "telephone_number": "989-791-3401",
            "fax_number": "989-791-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 TOWNE CTR",
            "address_2": "SUITE 202",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042818",
            "telephone_number": "989-791-3401",
            "fax_number": "989-791-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASENCIA FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "PLASENCIA",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-791-3401",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jplasencia1218@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "4705 Towne Ctr",
            "address_2": "Suite 202",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486042818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.