Organization Active NPI

Premier Hematology Oncology Care Inc

  • Hematology & Oncology Physician
  • Sterling Heights, MI
National Provider Identifier
1205126430
Registry record updated Apr 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4301091736 Issued in MI
Legal business name
PREMIER HEMATOLOGY ONCOLOGY CARE INC
Practice address
8244 Metro Pkwy
Suite a
Sterling Heights, MI 48312-2778
Phone
(586) 795-4060
NPI assigned
Apr 8, 2011
Last updated
Apr 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2011

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

Authorized official

Name
Savitha Kadakol, MDNPI 1477569176
Title
Physician President
Phone
(586) 795-4060

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
Hematology & Oncology Physician 207RH0003X 4301091736 MI Primary

Addresses

Primary practice location

8244 Metro Pkwy
Suite a
Sterling Heights, MI 48312-2778

Mailing address

8244 Metro Pkwy
Suite a
Sterling Heights, MI 48312-2778
Phone (586) 795-4060

Other identifiers 3

IdentifierTypeStateIssuer
4301091736OtherMILICENSE
1477569176MedicaidMI
5315035232OtherMICONTROLLED SUBSTANCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110713000584 MI Part B Supplier - Clinic/Group Practice 2365610557 Receives reassigned benefits from 2 practitioners
Practice locations: Rochester Hills, MI

National Provider Directory

National Provider Directory

Locations

8244 Metropolitan Pkwy
Ste A
Sterling Heights, MI 48312
Phone (586) 795-4060

Practitioners & affiliated clinicians

Practitioners 2

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": "1302220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1205126430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8244 METRO PKWY",
            "address_2": "SUITE A",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483122778",
            "telephone_number": "586-795-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8244 METRO PKWY",
            "address_2": "SUITE A",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483122778",
            "telephone_number": "586-795-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HEMATOLOGY ONCOLOGY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-08",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "KADAKOL",
        "authorized_official_first_name": "SAVITHA",
        "authorized_official_title_or_position": "PHYSICIAN PRESIDENT",
        "authorized_official_telephone_number": "586-795-4060",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301091736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301091736",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477569176",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "5315035232",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; 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.