NPIMap

Organization Active NPI

Covenant Pathology Associates, PC

Doing business as MI Health Clinic

  • Diagnostic Radiology Physician
  • Saginaw, MI
National Provider Identifier
1124779061
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
COVENANT PATHOLOGY ASSOCIATES, PC
Doing business as
MI Health Clinic
Practice address
4707 McLeod Dr E
Saginaw, MI 48604-2853
Phone
(989) 341-5078
NPI assigned
Jan 12, 2022
Last updated
Jan 12, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
COVENANT PATHOLOGY ASSOCIATES, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Dr. David L. Stockman, MDNPI 1407086424
Title
President
Phone
(989) 459-2300

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
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

4707 McLeod Dr E
Saginaw, MI 48604-2853

Mailing address

3925 Fortune Blvd
Saginaw, MI 48603-2287
Phone (989) 459-2300

Other practice location 1

3925 Fortune Blvd
Saginaw, MI 48603-2287
Phone (989) 459-2300

Other names 1

  • MI Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, DC, IL, CA, FL, NC6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20040405000837 MI Part B Supplier - Clinic/Group Practice 5991798183 Receives reassigned benefits from 7 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bad Axe, MI; Cass City, MI; Saginaw, MI
O20220304001991 DC Part B Supplier - Clinic/Group Practice 5991798183 Receives reassigned benefits from 1 practitioner
Practice locations: Gaithersburg, MD
O20220309001012 IL Part B Supplier - Clinic/Group Practice 5991798183 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL
O20220314000533 CA Part B Supplier - Clinic/Group Practice 5991798183 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Monica, CA
O20220315000047 FL Part B Supplier - Clinic/Group Practice 5991798183 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Lauderdale, FL
O20220413001435 NC Part B Supplier - Clinic/Group Practice 5991798183 Receives reassigned benefits from 1 practitioner
Practice locations: Littleton, NC

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Covenant Pathology Assoc PC

Locations

345 E Ohio St
Chicago, IL 60611
Phone (630) 200-0650

4675 Hill St
Cass City, MI 48726
Phone (989) 872-2121

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1124779061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 FORTUNE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032287",
            "telephone_number": "989-459-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 MCLEOD DR E",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042853",
            "telephone_number": "989-341-5078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3925 Fortune Blvd",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486032287",
            "country_code": "US",
            "telephone_number": "989-459-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COVENANT PATHOLOGY ASSOCIATES, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COVENANT PATHOLOGY ASSOCIATES, PC",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "STOCKMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-459-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MI Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.