Active NPI
Allan Faust, PA-C
- Physician Assistant
- Portage, MI
National Provider Identifier
1396851473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601002043
- Practice address
- 7901 Angling Rd
Portage, MI 49024-0714 - Phone
- (269) 324-8405
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601002043 | MI | Primary |
Addresses
Primary practice location
7901 Angling Rd
Portage, MI 49024-0714
Mailing address
3035 S 26TH St
Kalamazoo, MI 49048-9610
Phone (269) 383-4285
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 757-4431 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601002043 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396851473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3035 S 26TH ST",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490489610",
"telephone_number": "269-383-4285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7901 ANGLING RD",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490240714",
"telephone_number": "269-324-8405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAUST",
"first_name": "ALLAN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601002043",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "757-4431",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.