ST. MARYS PLASTIC, RECONSTRUCTIVE, COSMETIC AND HAND SURGERY (ASCENSION ST. MARY'S HOSPITAL) NPI 1649597998

Plastic Surgery in Saginaw, MI

NPI 1649597998 Organization Plastic Surgery

About ST. MARYS PLASTIC, RECONSTRUCTIVE, COSMETIC AND HAND SURGERY (ASCENSION ST. MARY'S HOSPITAL)

St. Marys Plastic, Reconstructive, Cosmetic And Hand Surgery (ascension St. Mary's Hospital) is a provider established in Saginaw, Michigan specializing in plastic surgery. The NPI number of St. Marys Plastic, Reconstructive, Cosmetic And Hand Surgery (ascension St. Mary's Hospital) is 1649597998 and was assigned on April 2010. The practitioner's primary taxonomy code is 208200000X with license number 5101015176 (MI). The provider is registered as an organization and their NPI record was last updated one year ago. St. Marys Plastic, Reconstructive, Cosmetic And Hand Surgery (ascension St. Mary's Hospital) operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as St. Marys Plastic, Reconstructive, Cosmetic And Hand Surgery. The authorized official of this NPI record is Laurie Mccord (Enrollment Coordinator)

NPI

1649597998

Provider NameST. MARYS PLASTIC, RECONSTRUCTIVE, COSMETIC AND HAND SURGERY (ASCENSION ST. MARY'S HOSPITAL)
Provider Location Address4705 TOWNE CTR SUITE 104 SAGINAW, MI 48604
Provider Mailing AddressPO BOX 779 TAWAS CITY, MI 48764
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameST. MARYS PLASTIC, RECONSTRUCTIVE, COSMETIC AND HAND SURGERY
Other Name TypeDoing Business As (3)
Enumeration Date04-27-2010
Last Update Date08-03-2020


Primary Taxonomy

Taxonomy Code208200000X
ClassificationPlastic Surgery
TypeAllopathic & Osteopathic Physicians
License No.5101015176
License StateMI
Taxonomy DescriptionA plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Business Address

ST. MARYS PLASTIC, RECONSTRUCTIVE, COSMETIC AND HAND SURGERY
4705 TOWNE CTR
SUITE 104
SAGINAW, MI
ZIP 48604
Phone: (989) 497-3157
Fax: (989) 497-3158

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Mailing Address

ST. MARYS PLASTIC, RECONSTRUCTIVE, COSMETIC AND HAND SURGERY
PO BOX 779
TAWAS CITY, MI
ZIP 48764
Phone: (989) 497-3157
Fax: (989) 497-3158



Authorized Official

Authorized Official Name LAURIE MCCORD
Authorized Official TitleENROLLMENT COORDINATOR
Authorized Official Phone(989) 362-9411

Group Taxonomy


193400000X MULTIPLE SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
12082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand5101015176MINo

Taxonomy Description: a plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.

22086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery5101015176MINo

Taxonomy Description: a surgeon who specializes in plastic and reconstructive surgery.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1639263098MEDICAID (05)MI

Other Providers at the same location


The following 11 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1306830963 NIKOLAI KINACHTCHOUK M.D.
Individual
Internal Medicine4705 TOWNE CTR SUITE 102
SAGINAW, MI 48604
(989) 790-2984
1760466346 JORGE PLASENCIA M.D.
Individual
Family Medicine4705 TOWNE CTR SUITE 202
SAGINAW, MI 48604
(989) 791-3401
1568630952JEFFREY R LEVIN MD PC
Organization
Psychiatry & Neurology (Neurology)4705 TOWNE CTR STE 302
SAGINAW, MI 48604
(989) 249-8001
1285806471JACOB C. NINAN MD PC
Organization
Internal Medicine (Hematology & Oncology)4705 TOWNE CTR SUITE 204
SAGINAW, MI 48604
(989) 799-6110
1134496292 JENNIFER RADEWAHN PA
Individual
Physician Assistant4705 TOWNE CTR STE 102
SAGINAW, MI 48604
(989) 790-2941
1124012786 LIOUDMILA KINACHTCHOUK M.D.
Individual
Internal Medicine4705 TOWNE CTR SUITE 102
SAGINAW, MI 48604
(989) 790-2984
1063739654ASCENSION ST. MARY'S HOSPITAL
Organization
Surgery (Trauma Surgery)4705 TOWNE CTR SUITE 104
SAGINAW, MI 48604
(989) 497-3157
1851327159DR. DEBASISH MRIDHA M.D.
Individual
Psychiatry & Neurology (Neurology)4705 TOWNE CTR SUITE 201
SAGINAW, MI 48604
(989) 799-2770
1003004086MICHIGAN ADVANCED NEUROLOGY CENTER, PLLC
Organization
Psychiatry & Neurology (Neurology)4705 TOWNE CTR STE. 201
SAGINAW, MI 48604
(989) 799-2770
1982642898PLASENCIA FAMILY MEDICINE PLLC
Organization
Family Medicine4705 TOWNE CTR SUITE 202
SAGINAW, MI 48604
(989) 791-3401
1639263098DR. WILLIAM JOHN PITTAS D.O.
Individual
Surgery (Plastic and Reconstructive Surgery)4705 TOWNE CTR SUITE 104
SAGINAW, MI 48604
(989) 497-3157

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.