Individual provider Active NPI

Katherine Elizabeth Wasek

  • Physician Assistant
  • Clinton TWP, MI
National Provider Identifier
1205237302
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007131 Issued in MI
Practice address
16510 19 Mile Rd
Clinton TWP, MI 48038-1106
Phone
(586) 263-7200
NPI assigned
Sep 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007131 MI Primary

Addresses

Primary practice location

16510 19 Mile Rd
Clinton TWP, MI 48038-1106

Mailing address

750 Stephenson Hwy
Troy, MI 48083-1103
Phone (248) 577-4995

Other practice location 1

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-8912

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwasek@mwcd.emadirect.md Other

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140924001710 MI Practitioner - Physician Assistant 3971722950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Center for Dermatology and Pathology PLLCGroup PAC ID 0446330492, 49 clinicians

Practice addresses (Care Compare)

43900 Garfield Rd
Clinton Township, MI 48038-1137
Phone (586) 286-0112

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.46 of 100Reported as group
Quality
91.13
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601007131MIMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: kwasek@mwcd.emadirect.md

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1205237302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 STEPHENSON HWY",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831103",
            "telephone_number": "248-577-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16510 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381106",
            "telephone_number": "586-263-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-8912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASEK",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwasek@mwcd.emadirect.md",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "direct email",
            "address_1": "16510 19 Mile Rd",
            "city": "Clinton Twp",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480381106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

Verify at the official NPI Registry.