Individual provider Active NPI

Yvonne V Pacquing, M.D.

  • Pediatrics Physician
  • Saginaw, MI
National Provider Identifier
1215032644
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301056422 Issued in MI
Practice address
4684 Wenmar Dr
Saginaw, MI 48604-2817
Phone
(989) 793-6373
Fax
(989) 793-7649
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301056422 MI Primary

Addresses

Primary practice location

4684 Wenmar Dr
Saginaw, MI 48604-2817

Mailing address

4855 Berl Dr
Saginaw, MI 48604-2832
Phone (989) 793-6373

Other practice location 1

4855 Berl Dr
Saginaw, MI 48604
Phone (989) 793-1202

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
I20210211003117 MI Practitioner - Pediatric Medicine 8426139445

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301056422MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Pediatric Partners PLLC Pediatrics CurrentSince Feb 3, 2021 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

4684 Wenmar Dr
Saginaw, MI 48604
Phone (989) 793-1095

4855 Berl Dr
Saginaw, MI 48604
Phone (989) 793-1202

Interoperability endpoints

  • Direct secure messaging: yvonnepacquing@sppllc.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1215032644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 BERL DR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042832",
            "telephone_number": "989-793-6373",
            "fax_number": "989-793-7649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4684 WENMAR DR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042817",
            "telephone_number": "989-793-6373",
            "fax_number": "989-793-7649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4855 Berl Dr",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "48604",
            "country_code": "US",
            "telephone_number": "989-793-1202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACQUING",
        "first_name": "YVONNE",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301056422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.