OTTO GAGO (NPI# 1902908684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902908684 |
| Entity Type | Individual |
| Full Name | OTTO GAGO |
| Credential | MD |
| Practice Address |
5325 Elliott Dr Suite 102 Ypsilanti MI 48197-8633 |
| Practice Telephone | 7347125500 |
| Practice Fax Number | 7347128209 |
| Mailing Telephone | 7347125500 |
| Mailing Fax Number | 7347128209 |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4301032553 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
5325 ELLIOTT DR SUITE 102 |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-8633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245237387 | Susan R. Illikman | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2005-07-05 |
| 1710533799 | Catherine I Giles | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2019-08-14 |
| 1083102214 | Christine Glowacki | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2018-04-24 |
| 1619488384 | Elizabeth H Stalder | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197 | 2017-10-20 |
| 1609312420 | Terri Lynn Trombley | Registered Nurse | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2017-01-18 |
| 1235685041 | Diana Rego | Nurse Practitioner | 5325 Elliott Dr, Suite 104, Ypsilanti, MI 48197-8633 | 2016-08-31 |
| 1184170524 | Cristina Hauncher | Dietitian, Registered | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-26 |
| 1629524194 | Zachary Ryan York | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-25 |
| 1225583362 | Kathleen Ritzert | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-18 |
| 1902359094 | St Joseph Mercy Hospital | Clinic/Center | 5325 Elliott Dr, Sutie 105, Ypsilanti, MI 48197-8633 | 2016-07-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
| Find all providers in zip 48197 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922349307 | Iha Health Service Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5325 Elliott Dr, Suite 102, Ypsilanti, MI 48197-8633 | 2013-03-08 |
| 1043492341 | Ajay Gupta | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5325 Elliott Dr, Suite Number 102, Ypsilanti, MI 48197-8633 | 2007-11-29 |
| 1023216777 | Melanie Andene Edwards | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5325 Elliott Dr Ste 102, Ypsilanti, MI 48197 | 2007-07-04 |
| 1932125986 | Vita V Mccabe | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5325 Elliott Dr, Suite 102, Ypsilanti, MI 48197-4633 | 2006-07-14 |
| 1013943083 | Bobby Kipak Kong | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5325 Elliott Dr, Suite # 102, Ypsilanti, MI 48197-8633 | 2006-06-23 |
| 1750377206 | Andrew Lee Pruitt | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5325 Elliott Dr, Suite 102, Ypsilanti, MI 48197-8633 | 2005-09-21 |
| 1558357004 | Manak Sood | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5325 Elliott Dr, Suite 102, Ypsilanti, MI 48197-8633 | 2005-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710479191 | United Surgical Associates Pllc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2150 Association Dr, Okemos, MI 48864-4909 | 2018-06-01 |
| 1841719531 | Liberty Cardiolvascular Group Pllc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 5250 Auto Club Dr Ste 300l, Dearborn, MI 48126-2619 | 2017-09-13 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1871982249 | Michigan Heart Lung and Vein Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2757 Leonard Ne, Ste 200, Grand Rapids, MI 49525-5807 | 2015-01-22 |
| 1154767382 | Michigan Thoracic Institute, PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6640 Kings Ct, West Bloomfield, MI 48322-2779 | 2013-05-15 |
| 1679815898 | Hanna Park | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 100 Michigan St Ne Rm 8830, Grand Rapids, MI 49503 | 2013-03-26 |
| 1760730469 | Hurley Medical Center | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1125 S. Linden Road, Suite 700, Flint, MI 48532-4069 | 2012-08-28 |
| 1245588326 | Bakri Kaakeh | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4701 Towne Centre Rd Ste 301, Saginaw, MI 48604-2800 | 2012-08-21 |
| 1447521554 | Eduardo Arciniegas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3236 Interlaken St, West Bloomfield, MI 48323-1824 | 2012-01-20 |
| 1629358650 | Steven S. Demos | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3739 Highgate Rd, Norton Shores, MI 49441-5017 | 2011-08-22 |
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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.