Individual provider Active NPI

Nadezhda Krasik, PA

  • Physician Assistant
  • Troy, MI
National Provider Identifier
1467009134
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2891 E Maple Rd # 102S-102
Troy, MI 48083-6106
Phone
(485) 249-0852
Fax
(248) 524-9086
NPI assigned
Aug 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2891 E Maple Rd # 102S-102
Troy, MI 48083-6106

Mailing address

2598 Buckingham Ave
Birmingham, MI 48009-7549
Phone (248) 797-0662

Other names 1

  • Nadezhda Brezhneva Other name

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
I20190916000062 MI Practitioner - Physician Assistant 6709115843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Medical Practice PCGroup PAC ID 7214982784, 4 clinicians

Practice addresses (Care Compare)

2891 E Maple Rd
Suite 102
Troy, MI 48083-6103
Phone (248) 524-9085

2891 E Maple Rd
Suite 102
Troy, MI 48083-6106

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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.

Hospital & facility affiliations 3

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": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1467009134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2598 BUCKINGHAM AVE",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097549",
            "telephone_number": "248-797-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2891 E MAPLE RD # 102S-102",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480836106",
            "telephone_number": "485-249-0852",
            "fax_number": "248-524-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASIK",
        "first_name": "NADEZHDA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NADEZHDA",
            "last_name": "BREZHNEVA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.