NPIMap

Organization Active NPI

Elizabeth a Pensler DO PLLC

Doing business as Pensler Vein and Vascular Sugical Institute

  • Vascular Surgery Physician
  • Ferndale, MI
National Provider Identifier
1255704805
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
5101017420 Issued in MI
Legal business name
ELIZABETH A PENSLER DO PLLC
Doing business as
Pensler Vein and Vascular Sugical Institute
Practice address
928 E 10 Mile Rd Ste 400
Ferndale, MI 48220-3041
Phone
(248) 268-4296
Fax
(888) 850-3877
NPI assigned
Nov 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Authorized official

Name
Elizabeth Pensler, DONPI 1659577963
Title
Medical Director/Owner
Phone
(586) 751-3480

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
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X 5101017420 MI Primary

Addresses

Primary practice location

928 E 10 Mile Rd Ste 400
Ferndale, MI 48220-3041

Mailing address

PO Box 71587
Madison Heights, MI 48071-0587
Phone (586) 751-3480

Other names 1

  • PENSLER VEIN AND VASCULAR SUGICAL INSTITUTE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160203001031 MI Part B Supplier - Clinic/Group Practice 6305140880 Receives reassigned benefits from 7 practitioners
Practice locations: Farmington Hills, MI; Ferndale, MI; Southgate, MI

National Provider Directory

National Provider Directory

Locations

928 E 10 Mile Rd
Ferndale, MI 48220
Phone (248) 268-4296

Practitioners & affiliated clinicians

Practitioners 9

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": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1255704805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71587",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480710587",
            "telephone_number": "586-751-3480",
            "fax_number": "888-850-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 E 10 MILE RD STE 400",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482203041",
            "telephone_number": "248-268-4296",
            "fax_number": "888-850-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH A PENSLER DO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A",
        "authorized_official_last_name": "PENSLER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "586-751-3480",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "5101017420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PENSLER VEIN AND VASCULAR SUGICAL INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ferndale, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; 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.