Pavilion Family Practice PC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

PAVILION FAMILY PRACTICE PC

Practice address

23077 Greenfield Rd
Suite 195
Southfield, MI 48075-3709

Phone

(248) 423-0700

Fax

(248) 423-0707

NPI assigned

Aug 15, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Stanley K Saunders, M.D

Title

President

Phone

(248) 423-0700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IAFDBA

Practitioners 5

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

• Sean Harris, M.D.

  • Family Medicine Physician
  • Southfield, MI
  • NPI 1457465213
  Medicare reassignment Care Compare group NPD
• Lorenzo Ray Mata Lim, D.O.

  • Family Medicine Physician
  • Southfield, MI
  • NPI 1194104885
  Medicare reassignment Care Compare group NPD
• Christyne Ella Lawson, M.D.

  • Family Medicine Physician
  • Bingham Farms, MI
  • NPI 1063522506
  NPD (past)
• Nancy Michael

  • Nurse Practitioner
  • Farmington Hills, MI
  • NPI 1609357078
  NPD (past)
• Al Lagman Romero, MD

  • Family Medicine Physician
  • Escanaba, MI
  • NPI 1295736114
  NPD (past)

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236211200000",
    "number": "1346432184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1547 MOMENTUM PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606895315",
            "telephone_number": "248-423-0700",
            "fax_number": "248-423-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD",
            "address_2": "SUITE 195",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753709",
            "telephone_number": "248-423-0700",
            "fax_number": "248-423-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION FAMILY PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2009-03-05",
        "status": "A",
        "authorized_official_last_name": "SAUNDERS",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-423-0700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kinnus Paul
• Maryann Paul, M.D
• Richard Paul, M.D.
• Sharon L Paul, LMSW
• Cindy Pavicic, B.S., D.P.M.
• Pavilion Imaging, LLC
• Kaia Pawloski
• Andrew Jason Payne, MD
• Angela S. Payne, LLPC
• Robert Payne

• Exclusive Provider Organization in Southfield, MI
• Providers in Southfield, MI by specialty
• Exclusive Provider Organization in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.