Prosperity Health PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PROSPERITY HEALTH PC

Practice address

41000 Woodward Ave Ste 350
Bloomfield Hills, MI 48304-5092

Phone

(248) 997-4242

Fax

(248) 997-4243

NPI assigned

Jul 9, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nishath K Hakim, MDNPI 1083694830

Title

Ceo

Phone

(248) 997-4242

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nishath K Hakim, MD

  • Internal Medicine Physician
  • Bloomfield Hills, MI
  • NPI 1083694830
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1003434754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41000 WOODWARD AVE STE 350",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045092",
            "telephone_number": "248-997-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41000 WOODWARD AVE STE 350",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045092",
            "telephone_number": "248-997-4242",
            "fax_number": "248-997-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERITY HEALTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "HAKIM",
        "authorized_official_first_name": "NISHATH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-997-4242",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1083694830",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301063552",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "practicefusion.com",
            "affiliation": "N",
            "address_1": "41000 Woodward Ave Ste 350",
            "city": "Bloomfield Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483045092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Lisa Provenzano, N.P.
• Thomas Michael Pullman, DR OF DENTAL SURGERY
• Simi Pullukat, M.D.
• Pure Joy Pediatrics, P.C.
• Kasturi B Puri, M.D

• Health Service Clinic/Center in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Health Service Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.