Organization Active NPI

Clara Kamath-Wood MD PLLC

  • Family Medicine Physician
  • Roseville, MI
National Provider Identifier
1073256145
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLARA KAMATH-WOOD MD PLLC
Practice address
18245 E 10 Mile Rd Ste 120
Roseville, MI 48066-5807
Phone
(586) 265-2680
Fax
(586) 265-2240
NPI assigned
Apr 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
Clara Kamath-Wood, MDNPI 1548377328
Title
Owner
Phone
(586) 265-2680

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

18245 E 10 Mile Rd Ste 120
Roseville, MI 48066-5807

Mailing address

PO Box 3272
Saginaw, MI 48605-3272
Phone (989) 797-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220506002091 MI Part B Supplier - Clinic/Group Practice 6507243854 Receives reassigned benefits from 1 practitioner
Practice locations: Roseville, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2258107Clara Kamath Wood MD PLLC18245 10 Mile Suite 120, Roseville, MI 48066Certificate of waiverApr 17, 2028

National Provider Directory

National Provider Directory

Locations

18245 E 10 Mile Rd
Ste 120
Roseville, MI 48066
Phone (586) 265-2680

Practitioners & affiliated clinicians

Practitioners 1

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": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1073256145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3272",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486053272",
            "telephone_number": "989-797-1400",
            "fax_number": "989-797-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18245 E 10 MILE RD STE 120",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480665807",
            "telephone_number": "586-265-2680",
            "fax_number": "586-265-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARA KAMATH-WOOD MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "KAMATH-WOOD",
        "authorized_official_first_name": "CLARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-265-2680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.