Padma Padival

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AG03220068 Issued in MI

Practice address

15150 Fort St
Southgate, MI 48195-1302

Phone

(734) 282-4800

NPI assigned

Apr 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ppadival1041694@direct.hfhs.org

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.

• Downriver Heart and Vascular Specialists PC

  • Interventional Cardiology Physician
  • Southgate, MI
  • NPI 1194838383
  NPD

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1295478113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45948 WINDRIDGE LN",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481886223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15150 FORT ST",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481951302",
            "telephone_number": "734-282-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADIVAL",
        "first_name": "PADMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "AG03220068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Osugi
• Althea Overall
• Ebenezer Owusu
• Elisabeth Oz
• Tiffani Anne Pacheco, MSW
• Brittany Nicole Page, LLMSW
• Sherelle J Palmer, LLMSW
• Joshua Paul Panter, LMSW
• Melissa Ann Panter
• Michelle Lorraine Pardee, DNP, FNP-BC

• Gerontology Nurse Practitioner in Southgate, MI
• Providers in Southgate, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.