MEMAC ASSOCIATES, PC (NPI# 1083663652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083663652 |
Entity Type | Organization |
Organization Name | MEMAC ASSOCIATES, PC |
Practice Address |
11800 E 12 Mile Rd Anesthesia Department Warren MI 48093-3472 |
Mailing Address |
7 W Square Lake Rd Bloomfield Hills MI 48302-0462 |
Practice Telephone | 5865735260 |
Mailing Telephone | 5865735260 |
Enumeration Date | 2006-05-09 |
Last Update Date | 2020-08-22 |
Authorized Official Name | HORACIO G. LARDO (PRESIDENT) |
Authorized Official Telephone | 5865735267 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
X | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | AETNA | 4484310 | 01 |
Street Address |
11800 E 12 MILE RD ANESTHESIA DEPARTMENT |
City | WARREN |
State | MI |
Zip Code | 48093-3472 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740280940 | Manisha Kaur Bajwa | Pharmacist | 11800 E 12 Mile Rd, Pharmacy Department, Warren, MI 48093-3472 | 2005-07-28 |
1679181986 | Roxana Lionte | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-07-22 |
1649893355 | Patrick Yang | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-05-28 |
1831711936 | Elisheva Ellenberg | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-05-12 |
1427686716 | Pavan Kumar Ravipati | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-31 |
1962038885 | Natasha Mehta | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-23 |
1194350645 | Katherine Sara Streidl | Nurse Anesthetist, Certified Registered | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-05 |
1891326898 | Clara Poparad-stezar | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-01-28 |
1023653797 | Lauren Ashley Shailor | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2019-11-16 |
1700428984 | Olivia Lynn Hedman | Dietitian, Registered | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2019-10-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
1679112676 | Open Heart Communities | Case Management | 31310 Shaw Dr, Warren, MI 48093 | 2019-12-23 |
1538715636 | 3 Dove Medical Supplies | Durable Medical Equipment & Medical Supplies | 31201 Chicago Rd S Ste C101, Warren, MI 48093 | 2019-08-14 |
1568954600 | Schreiber Cardiology, P.C. | Internal Medicine | 8545 Common Rd Ste 150, Warren, MI 48093 | 2018-06-05 |
1730686197 | Lambro Seremetis | Social Worker | 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 | 2018-04-11 |
1649775826 | Ridge Downs | Behavioral Analyst | 31201 Chicago Rd South, Suite C- 202, Warren, MI 48093 | 2018-03-28 |
1144722737 | Jessica Farraj | Occupational Therapist | 11800 E. 12 Mile Road, Warren, MI 48093 | 2018-02-28 |
1265930168 | Leah Hanrahan | Registered Nurse | 11700 Amberle Dr., Warren, MI 48093 | 2018-01-25 |
1598271553 | Pamela Marie Confer | Occupational Therapist | 11012 13 Mile Rd, Suite 200, Warren, MI 48093 | 2017-12-28 |
1831604347 | Kate Jeanne Szczepanski | Behavior Technician | 31200 Chicago Rd S, Warren, MI 48093 | 2017-12-06 |
Find all providers in zip 48093 |
Taxonomy Code | 207LP2900X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Anesthesiology |
Specialization | Pain Medicine |
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730267188 | Jose Antonio Torres | Anesthesiology | 1806 E Market St, Warren, OH 44483-6616 | 2006-11-02 |
1255352241 | Warren Pain Clinic and Acupuncture Center, PC | Anesthesiology | 103 West St. Clair Street, Suite 2c, Warren, PA 16365-2188 | 2006-07-22 |
1306814561 | Kondraganti P Rao | Anesthesiology | 28111 Hoover, Warren, MI 48093 | 2006-03-14 |
1265713242 | Medcare Inc | Anesthesiology | 2243 E 12 Mile Rd, Warren, MI 48092-5644 | 2011-09-02 |
1649562307 | Daniel Feldman | Anesthesiology | 11900 E 12 Mile Rd, Suite 110, Warren, MI 48093-3400 | 2011-05-12 |
1194029272 | Syndolor Medical LLC | Anesthesiology | 1806 E Market St, Warren, OH 44483-6616 | 2011-01-04 |
1306011481 | Christina W Chin Md LLC | Anesthesiology | 100 Town Center Dr, Warren, NJ 07059-5692 | 2008-04-29 |
1659360931 | Mohamed A Kourtu | Anesthesiology | 2 W Crescent Park, Warren, PA 16365-2111 | 2005-10-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629568811 | Flint Pain Specialists Pllc | Anesthesiology | 1345 Willowdale Ct Ste B, Flint, MI 48532-4737 | 2018-05-14 |
1548624984 | Ayman Tarabishy Md Pllc | Anesthesiology | 400 Plymouth Rd, F2, Plymouth, MI 48170-1482 | 2016-04-12 |
1457733008 | John Sung Ha | Anesthesiology | 325 E Eisenhower Pkwy Ste 310, Ann Arbor, MI 48108-3307 | 2015-06-19 |
1841603362 | Clinton Pain and Anesthesia Plc | Anesthesiology | 16100 19 Mile Road, Clinton Township, MI 48038 | 2014-06-03 |
1255743738 | Advanced Pain Specialists | Anesthesiology | 18100 Oakwood Blvd Ste 203, Dearborn, MI 48124-4085 | 2014-06-02 |
1871931592 | Ihsan Asbahi | Anesthesiology | 1234 S Lapeer Rd, Lake Orion, MI 48360 | 2013-06-05 |
1265876403 | Medical Business Consultants, Ltd. | Anesthesiology | 63474 Zabel Shores Rd, Sturgis, MI 49091-9371 | 2013-04-18 |
1407198807 | Kevin M. Nemeth | Anesthesiology | 2060 East Paris Ave Se Ste 200, Grand Rapids, MI 49546-6113 | 2013-03-23 |
1891054573 | Eduardo Icaza | Anesthesiology | 36622 Five Mile Rd Ste 101, Livonia, MI 48154-1900 | 2012-05-15 |
1972884724 | Martin Ilan Noveck | Anesthesiology | 9255 Allen Rd, Clarkston, MI 48348-2726 | 2011-09-07 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.