Active NPI
Michael P Mesaros, MD
- Ophthalmology Physician
- Saginaw, MI
National Provider Identifier
1992790703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 4301026069
- Practice address
- 2393 Schust Rd
Saginaw, MI 48603-1334 - Phone
- (989) 793-2820
- Fax
- (989) 755-1463
- NPI assigned
- Sep 19, 2005
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 4301026069 | MI | Primary |
Addresses
Primary practice location
2393 Schust Rd
Saginaw, MI 48603-1334
Mailing address
2393 Schust Rd
Saginaw, MI 48603-1334
Phone (989) 793-2820
Other practice location 1
407 Wackerly Rd
Great Lakes Eye Institute
Midland, MI 48640
Phone (989) 631-1345
Other practice location 2
407 Wackerly Rd
Great Lakes Eye Institute
Midland, MI 48640
Phone (989) 631-1345
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0G30089 | Other | BCBSM GROUP ID | |
| 1427090976 | Other | GROUP NPI | |
| 0G36036 | Other | MEDICARE GROUP ID | |
| 4156171 | Medicaid | MI | |
| CA3610 | Other | RAILROAD MEDICARE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301026069 | MI | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1992790703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2393 SCHUST RD",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486031334",
"telephone_number": "989-793-2820",
"fax_number": "989-755-1463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2393 SCHUST RD",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486031334",
"telephone_number": "989-793-2820",
"fax_number": "989-755-1463"
}
],
"practiceLocations": [
{
"address_1": "407 Wackerly Rd",
"address_2": "Great Lakes Eye Institute",
"address_purpose": "LOCATION",
"city": "Midland",
"state": "MI",
"postal_code": "48640",
"country_code": "US",
"telephone_number": "989-631-1345",
"fax_number": "989-631-5129",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "407 Wackerly Rd",
"address_2": "Great Lakes Eye Institute",
"address_purpose": "LOCATION",
"city": "Midland",
"state": "MI",
"postal_code": "48640",
"country_code": "US",
"telephone_number": "989-631-1345",
"fax_number": "989-631-5129",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MESAROS",
"first_name": "MICHAEL",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-19",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MI",
"license": "4301026069",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM GROUP ID",
"identifier": "0G30089",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1427090976",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP ID",
"identifier": "0G36036",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4156171",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CA3610",
"state": null
}
],
"endpoints": [],
"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 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.