Individual provider Active NPI

Michele Caroline Willems Plakyda, MD

  • Pediatric Neurodevelopmental Disabilities Physician
  • Yardley, PA
National Provider Identifier
1437222478
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
License
MD073421 Issued in PA
Practice address
1004 Floral Vale Blvd
Yardley, PA 19067-5532
Phone
(267) 759-6736
Fax
(267) 759-6735
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X MD073421 PA Primary

Addresses

Primary practice location

1004 Floral Vale Blvd
Yardley, PA 19067-5532

Mailing address

1004 Floral Vale Blvd
Yardley, PA 19067-5532
Phone (267) 759-6736

Other identifiers 2

IdentifierTypeStateIssuer
1215591649MedicaidPA
1437222478MedicaidNJ

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD073421PAMDPediatric Neurodevelopmental Disabilities Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bucks Developmental Pediatrics Neurodevelopmental Disabilities CurrentSince Feb 7, 2021 Accepting new patients

Locations

1004 Floral Vale Blvd
Yardley, PA 19067
Phone (267) 759-6736

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1437222478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 FLORAL VALE BLVD",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190675532",
            "telephone_number": "267-759-6736",
            "fax_number": "267-759-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 FLORAL VALE BLVD",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190675532",
            "telephone_number": "267-759-6736",
            "fax_number": "267-759-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEMS PLAKYDA",
        "first_name": "MICHELE",
        "middle_name": "CAROLINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "PA",
            "license": "MD073421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215591649",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437222478",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yardley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.