Tina Pickett Baisden, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301057574 Issued in MI

Practice address

3990 John R St
Detroit, MI 48201-2018

Phone

(313) 577-5980

NPI assigned

Aug 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tpickett@mwcd.emadirect.md

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.

• University Physician Group

  dba Wayne Health

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797

  Dermatology

  Medicare reassignment NPD
• University Physician Group

  dba Wayne State University Physician Group

  • Counselor
  • Detroit, MI
  • NPI 1447465661
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1396753810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-577-5980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16510 19 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480381106",
            "country_code": "US",
            "telephone_number": "586-263-7200",
            "fax_number": "586-286-8007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKETT BAISDEN",
        "first_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301057574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070015591",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0706359621",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyna Pickens
• Latasha Nicole Pickens
• Lavetta Annette Pickens, NURSE PRACTITIONER
• Teddi Arielle Pickens
• Nicole Marie Pickersgill, CRNA
• Antoinette Pickett
• Dominique Pickett, CCMA
• Emmanuel Pickett Jr.
• Gloria Ann Pickett
• La Nita Bernice Pickett

• Dermatology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.