Bloomfield Hills Pediatrics

Primary specialty

SpecialistTaxonomy code 174400000X

License

FB035468 Issued in MI

Legal business name

BLOOMFIELD HILLS PEDIATRICS

Practice address

43750 Woodward Ave
Ste 104
Bloomfield Hills, MI 48302-5063

Phone

(248) 334-6000

Fax

(248) 334-8740

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Fidelina Nitura Baraceros, MDNPI 1841234622

Title

Owner

Phone

(248) 334-6000

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 2

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

• Fidelina Nitura Baraceros, MD

  • Pediatrics Physician
  • Bloomfield Hills, MI
  • NPI 1841234622
  NPD (past) Authorized official
• Preeti Thabolingam, MD

  • Pediatrics Physician
  • Bloomfield Hills, MI
  • NPI 1770604928
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346361946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43750 WOODWARD AVE",
            "address_2": "STE 104",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025063",
            "telephone_number": "248-334-6000",
            "fax_number": "248-334-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43750 WOODWARD AVE",
            "address_2": "STE 104",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025063",
            "telephone_number": "248-334-6000",
            "fax_number": "248-334-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMFIELD HILLS PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARACEROS",
        "authorized_official_first_name": "FIDELINA",
        "authorized_official_middle_name": "NITURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-334-6000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "FB035468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVID ID #",
            "identifier": "3506341231",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLAN ID",
            "identifier": "101152",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE NUMBER",
            "identifier": "FB035468",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bloomfield Family
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• Bloomfield Hills Care Group, Inc. (Bloomfield Hills Care Group)
• Bloomfield Hills Dental Group PLLC
• Bloomfield Hills Massage LLC
• Bloomfield Hills Rehab, LLC
• Bloomfield Hills SNF LLC (Illuminate HC Bloomfield Hills)
• Bloomfield Hills Surgery Center (Bloomfield Hills Surgical Center)
• Bloomfield Hills Surgery Center
• Bloomfield House, Inc

• Specialist in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Specialist in Michigan

• 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.