Individual provider Active NPI

Pamela Bartley

  • Physician Assistant
  • Portage, MI
National Provider Identifier
1063886505
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007475 Issued in MI
Practice address
7901 Angling Rd
Portage, MI 49024-0714
Phone
(269) 324-8600
NPI assigned
Nov 20, 2015
Last updated
Nov 20, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007475 MI Primary

Addresses

Primary practice location

7901 Angling Rd
Portage, MI 49024-0714

Mailing address

7901 Angling Rd
Portage, MI 49024-0714
Phone (269) 324-8600

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
I20160119002581 MI Practitioner - Physician Assistant 9739482175 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

3950 Hollywood Rd
Saint Joseph, MI 49085-9151

3950 Hollywood Rd
Saint Joseph, MI 49085-9158

42 N Saint Joseph Ave
Niles, MI 49120-2203

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601007475MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Promed CurrentSince Jan 4, 2016 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince May 1, 2024 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince May 1, 2024 Accepting new patients
Promed Healthcare CurrentSince Jan 4, 2016 Accepting new patients
Lakeland Medical Practices CurrentSince Dec 22, 2017 Accepting new patients

Locations

42 N Saint Joseph Ave
Ste 301
Niles, MI 49120
Phone (269) 428-0002

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

3950 Hollywood Rd
Ste 200
Saint Joseph, MI 49085
Phone (269) 556-1990

3950 Hollywood Rd
Ste 210
Saint Joseph, MI 49085
Phone (269) 556-1990

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

Interoperability endpoints

  • Direct secure messaging: pbartley1268437@epic00.corewelldirect.org

Organizations & group practices 7

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1063886505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 ANGLING RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490240714",
            "telephone_number": "269-324-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 ANGLING RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490240714",
            "telephone_number": "269-324-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLEY",
        "first_name": "PAMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.