Active NPI
Paul Herbert Izenberg, M.D.
- Plastic Surgery Physician
- Ypsilanti, MI
National Provider Identifier
1992727408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 4301037154
- Practice address
- 5333 McAuley Dr
Suite R5001
Ypsilanti, MI 48197-1014 - Phone
- (734) 712-2323
- Fax
- (734) 712-2312
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 4301037154 | MI | Primary |
Addresses
Primary practice location
5333 McAuley Dr
Suite R5001
Ypsilanti, MI 48197-1014
Mailing address
5333 McAuley Drive
Suite R5001
Ypsilanti, MI 48197
Phone (734) 712-2323
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102225 | Other | MI | CARE CHOICES HMO |
| P41548 | Other | MI | BLUE CARE NETWORK |
| 6976 | Other | MI | CAPE |
| B43925 | Other | MI | HEALTH ALLIANCE PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- pizenberg@cprs.gwaydirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992727408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5333 MCAULEY DRIVE",
"address_2": "SUITE R5001",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "48197",
"telephone_number": "734-712-2323",
"fax_number": "734-712-2312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5333 MCAULEY DR",
"address_2": "SUITE R5001",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481971014",
"telephone_number": "734-712-2323",
"fax_number": "734-712-2312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IZENBERG",
"first_name": "PAUL",
"middle_name": "HERBERT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "MI",
"license": "4301037154",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE CHOICES HMO",
"identifier": "102225",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE NETWORK",
"identifier": "P41548",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPE",
"identifier": "6976",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE PLAN",
"identifier": "B43925",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.