Individual provider Active NPI

Angelique Uwineza

  • Primary Care Nurse Practitioner
  • Mount Pleasant, MI
National Provider Identifier
1063162295
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704371242 Issued in MI
Practice address
1621 E Broomfield St Ste C
Mount Pleasant, MI 48858-5427
Phone
(989) 817-4600
NPI assigned
Mar 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704371242 MI Primary

Addresses

Primary practice location

1621 E Broomfield St Ste C
Mount Pleasant, MI 48858-5427

Mailing address

1621 E Broomfield St Ste C
Mount Pleasant, MI 48858-5427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220512002416 MI Practitioner - Nurse Practitioner 4183001191 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

900 Cooper Ave
Saginaw, MI 48602-5182
Phone (989) 583-6521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc. Current Accepting new patients
Prism Medical Associates, PC CurrentSince Dec 1, 2022 Accepting new patients
Covenant Medical Center, Inc CurrentSince Jul 30, 2024 Accepting new patients

Locations

255 E Warwick Dr
Alma, MI 48801
Phone (989) 463-4976

16440 Gratiot Rd
Hemlock, MI 48626
Phone (989) 583-0660

1621 E Broomfield St
Ste C
Mt Pleasant, MI 48858
Phone (989) 427-5320

900 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6122

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

Interoperability endpoints

  • Direct secure messaging: auwineza168442@direct.covenanthealthcare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1063162295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 E BROOMFIELD ST STE C",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488585427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 E BROOMFIELD ST STE C",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488585427",
            "telephone_number": "989-817-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UWINEZA",
        "first_name": "ANGELIQUE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704371242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, MI

Sources for this page

Verify at the official NPI Registry.