Evette N Elsenety, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

035480 Issued in MI

Practice address

27351 Dequindre Rd
Madison Heights, MI 48071-3487

Phone

(248) 967-7750

Fax

(248) 967-7297

NPI assigned

Jun 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Specialty

Pathology

Education

Other, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Langston Walker and Associates, P.C.Group PAC ID 1456443670, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: eelsenety1126209@direct.hfhs.org

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.

• Langston Walker & Associates, P.C.

  • Anatomic Pathology & Clinical Pathology Physician
  • Madison Heights, MI
  • NPI 1376527846
  Medicare reassignment Care Compare group
• St John Health System Oakland

  • Anatomic Pathology & Clinical Pathology Physician
  • Madison Heights, MI
  • NPI 1366470908
  NPD (past) Authorized official

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

• Henry Ford Health Macomb Oakland Hospital

  dba St. John Macomb Oakland Hospital-Warren Campus

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1124099858
  Care Compare affiliation
• Henry Ford Health Macomb Oakland Hospital

  dba St John Macomb Oakland - Oakland Center

  • General Acute Care Hospital
  • Madison Heights, MI
  • NPI 1215139233
  Care Compare affiliation

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383177600000",
    "number": "1164468500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27351 DEQUINDRE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713487",
            "telephone_number": "248-967-7750",
            "fax_number": "248-967-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSENETY",
        "first_name": "EVETTE",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2013-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "035480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MC",
            "identifier": "220021537",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "382032989",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3207140",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5214565",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "2206325081",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P00422257",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.