Provider Demographics
NPI:1558596015
Name:CARUSO, JENNIFER KRISTINE (DO)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:KRISTINE
Last Name:CARUSO
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 HOUGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-5303
Mailing Address - Country:US
Mailing Address - Phone:989-746-7500
Mailing Address - Fax:989-746-7723
Practice Address - Street 1:1000 HOUGHTON AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-5303
Practice Address - Country:US
Practice Address - Phone:989-746-7500
Practice Address - Fax:989-746-7723
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018168207V00000X, 207VM0101X
PAOS016329207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD065773500Medicaid
PA30153197OtherAMERIHEALTH CARITAS, PA - WMG - YWHC
PA420140OtherUPMC
PA1622982OtherGATEWAY
PA30152919OtherAMERIHEALTH CARITAS, PA - WMG - THFPC
PA30153194OtherAMERIHEALTH CARITAS, PA - WMG - MATERNAL FETAL MED.
PA30152902OtherAMERIHEALTH CARITAS, PA - YH OB TEACHING
PA30153192OtherAMERIHEALTH CARITAS, PA - WMG - WS YORK HOSP OB/GYN
PA102804570Medicaid
PA2884237OtherHIGHMARK BLUE SHIELD
PA30152919OtherAMERIHEALTH CARITAS, PA - WMG - THFPC
PA30153197OtherAMERIHEALTH CARITAS, PA - WMG - YWHC