NPIMap

Organization Active NPI

Cascor Health Systems PC

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1053462846
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
049430 Issued in MI
Legal business name
CASCOR HEALTH SYSTEMS PC
Practice address
4821 McNichols St
Detroit, MI 48212-1730
Phone
(313) 368-4600
Fax
(313) 368-4700
NPI assigned
Jan 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

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

Authorized official

Name
Dr. Sai Wentum, M.D.
Title
Ceo
Phone
(313) 368-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 049430 MI Primary

Addresses

Primary practice location

4821 McNichols St
Detroit, MI 48212-1730

Mailing address

4821 McNichols St
Detroit, MI 48212-1730
Phone (313) 368-4600

Other identifiers 1

IdentifierTypeStateIssuer
4529149MedicaidMI

Other names 1

  • East Park Medical Center Doing business as

National Provider Directory

National Provider Directory

Locations

13100 Harper Ave
Detroit, MI 48213
Phone (313) 822-3610

4821 E McNichols Rd
Hamtramck, MI 48212
Phone (313) 368-4600

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305849600000",
    "number": "1053462846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4821 MCNICHOLS ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121730",
            "telephone_number": "313-368-4600",
            "fax_number": "313-368-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4821 MCNICHOLS ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121730",
            "telephone_number": "313-368-4600",
            "fax_number": "313-368-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCOR HEALTH SYSTEMS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2011-05-20",
        "status": "A",
        "authorized_official_last_name": "WENTUM",
        "authorized_official_first_name": "SAI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-368-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "049430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4529149",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Park Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; 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.