Individual provider Active NPI

Priyanka Pandey, DO

  • Internal Medicine Physician
  • Warren, MI
National Provider Identifier
1326539248
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6052 Issued in TN
Practice address
11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone
(586) 576-1615
Fax
(855) 856-4154
NPI assigned
May 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5101027177 MI
Internal Medicine Physician 207R00000X 6052 TN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

11800 E 12 Mile Rd
Warren, MI 48093-3472

Mailing address

17125 W 14 Mile Rd
Beverly Hills, MI 48025-3225
Phone (248) 417-6625

Other practice location 1

12000 E 12 Mile Rd
Warren, MI 48093-3570
Phone (586) 576-4145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230906001392 MI Practitioner - Osteopathic Manipulative Medicine 6800222340 Reassigns benefits to 1 organization
I20250717000665 TN Practitioner - General Practice 6800222340 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6052TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC General Practice CurrentSince Aug 1, 2023 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital Past Accepting new patients

Locations

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

300 Montvue Rd
Knoxville, TN 37919
Phone (818) 613-6769

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

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": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1326539248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17125 W 14 MILE RD",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480253225",
            "telephone_number": "248-417-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-576-1615",
            "fax_number": "855-856-4154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12000 E 12 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480933570",
            "country_code": "US",
            "telephone_number": "586-576-4145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANDEY",
        "first_name": "PRIYANKA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101027177",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "6052",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.