Bhavana Vyas MD PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

BHAVANA VYAS MD PLLC

Practice address

43475 Dalcoma Dr Ste 208
Clinton TWP, MI 48038-3593

Phone

(586) 263-1818

Fax

(586) 314-6044

NPI assigned

Jun 24, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Bhavana Vyas, M.D.

Title

President

Phone

(586) 263-1818

Specialties & licenses 2

Addresses

Other names 1

• Macomb Medical Pediatrics Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1427430677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA DR STE 208",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383593",
            "telephone_number": "586-263-1818",
            "fax_number": "586-314-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA DR STE 208",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383593",
            "telephone_number": "586-263-1818",
            "fax_number": "586-314-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHAVANA VYAS MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-24",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "VYAS",
        "authorized_official_first_name": "BHAVANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-263-1818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Macomb Medical Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Macomb Medical Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bradley Carl Berger, MD
• Amber Sharee Bernard, COTAL
• Colleen Bertani, MSW
• Serena Beshi, PA-C
• Rajesh C Bhagat, MD
• Phyllis Ann Billings-McNeil, L.B.S.W
• Jenay Binionscott
• Samuel Gregg Blanchard, D.D.S., M.S.
• Lawrence R Blaty, M.D.
• Julie Blazejewski, B.S.

• Pediatrics Physician in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.