AGUSTIN FELIPE GAVIDIA ROSARIO M.D.
NPI 1588403174
Student in an Organized Health Care Education/Training Program in Detroit, MI

Q: What is Agustin Gavidia Rosario's NPI number?

The NPI number for Agustin Gavidia Rosario is 1588403174. It was assigned to this individual provider in the NPPES registry on May 22, 2024.

Q: What is Agustin Gavidia Rosario's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since May 22, 2024PECOS Enrolled

2799 W GRAND BLVD, DETROIT, MI 48202(313) 916-2600 Get Directions Write a Review

NPPES record last updated: September 17, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Agustin Felipe Gavidia Rosario M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AGUSTIN FELIPE GAVIDIA ROSARIO M.D. (NPI 1588403174) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588403174

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameAGUSTIN FELIPE GAVIDIA ROSARIOCredential: M.D.

Location Address2799 W GRAND BLVDDetroit, MI 48202

Mailing AddressCalle Los Sauces 377 Apt 501, San IsidroLima, LIMA 15073

Phone(313) 916-2600

Sole ProprietorNo

Enumeration DateMay 22, 2024

Last NPPES UpdateSeptember 17, 2024

✔ NPI 1588403174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2799 W GRAND BLVD, Detroit, MI 48202

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Agustin Felipe Gavidia Rosario M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HENRY FORD HOSPITAL

General Acute Care Hospital