NPIMap

Organization Active NPI

Dr. Dinesh Nayak, MD, P.C.

  • Pediatrics Physician
  • Southgate, MI
National Provider Identifier
1235284233
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
DN065279 Issued in MI
Legal business name
DR. DINESH NAYAK, MD, P.C.
Doing business as
Pediatric & Adolescent Center
Practice address
15255 Northline Rd
Southgate, MI 48195-2487
Phone
(734) 285-3090
Fax
(734) 285-3095
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dinesh Nayak, MDNPI 1568430502
Title
President of the Corporation
Phone
(734) 285-3090

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X DN065279 MI Primary

Addresses

Primary practice location

15255 Northline Rd
Southgate, MI 48195-2487

Mailing address

15255 Northline Rd
Southgate, MI 48195-2487
Phone (734) 285-3090

Other identifiers 5

IdentifierTypeStateIssuer
C7880OtherMCARE ID
4433530MedicaidMI
022809OtherMIDWEST HEALTH PLAN
132436OtherCARE CHOICES ID
5885732OtherAETNA

Other names 1

  • Pediatric & Adolescent Center Doing business as

National Provider Directory

National Provider Directory

Locations

7445 Allen Rd
Ste 120
Allen Park, MI 48101
Phone (313) 388-9541

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235284233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15255 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952487",
            "telephone_number": "734-285-3090",
            "fax_number": "734-285-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15255 NORTHLINE RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952487",
            "telephone_number": "734-285-3090",
            "fax_number": "734-285-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DINESH NAYAK, MD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NAYAK",
        "authorized_official_first_name": "DINESH",
        "authorized_official_title_or_position": "PRESIDENT OF THE CORPORATION",
        "authorized_official_telephone_number": "734-285-3090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "DN065279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE ID",
            "identifier": "C7880",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4433530",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH PLAN",
            "identifier": "022809",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES ID",
            "identifier": "132436",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5885732",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric & Adolescent Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.