Individual provider Active NPI

Kathy Lynn Bashawaty, MSN, FNP-BC

  • Family Nurse Practitioner
  • West Bloomfield, MI
National Provider Identifier
1386935955
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704190275 Issued in MI
Practice address
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone
(248) 325-1000
NPI assigned
Apr 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704190275 MI Primary

Addresses

Primary practice location

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Mailing address

1407 Vinsetta Blvd
Royal Oak, MI 48067-1028
Phone (248) 439-0209

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbashawathy411861@direct.hfhs.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150407001682 MI Practitioner - Nurse Practitioner 4789902594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

6773 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-6100

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-4100

Hospital & facility affiliations

  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704190275MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince May 5, 2016 Accepting new patients
Henry Ford Health System Nurse Practitioner CurrentSince May 5, 2016 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: kbashawathy411861@direct.hfhs.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1386935955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 VINSETTA BLVD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671028",
            "telephone_number": "248-439-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "248-325-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHAWATY",
        "first_name": "KATHY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-29",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704190275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbashawathy411861@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "6777 W Maple Rd",
            "city": "West Bloomfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483223013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.