Individual provider Active NPI

Pauline Chiu, M.D.

  • Family Medicine Physician
  • Okemos, MI
National Provider Identifier
1093867046
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD0000030075 Issued in TN
Practice address
2205 Jolly Rd
Suite B
Okemos, MI 48864-3983
Phone
(517) 347-4085
Fax
(517) 347-4170
NPI assigned
Jan 18, 2007
Last updated
Aug 4, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD0000030075 TN Primary

Addresses

Primary practice location

2205 Jolly Rd
Suite B
Okemos, MI 48864-3983

Mailing address

PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6622

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090105000556 MI Practitioner - Family PracticePractitioner - Internal MedicinePractitioner - Emergency Medicine 8224012224 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000030075TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc CurrentSince Sep 1, 2013 Accepting new patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
Wa Foote Memorial Hospital Inc Family Medicine CurrentSince Sep 1, 2013 Accepting new patients
Millbrook Medical Center Family Medicine Past Accepting new patients

Locations

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

Interoperability endpoints

  • Direct secure messaging: pchiu462855@direct.hfhs.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1093867046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239",
            "telephone_number": "248-824-6622",
            "fax_number": "248-324-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 JOLLY RD",
            "address_2": "SUITE B",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643983",
            "telephone_number": "517-347-4085",
            "fax_number": "517-347-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIU",
        "first_name": "PAULINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000030075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.