Individual provider Active NPI

Colleen Pingston, PA

  • Physician Assistant
  • Sterling Heights, MI
National Provider Identifier
1467624023
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
CM005015 Issued in MI
Practice address
14460 Lakeside Circle
100
Sterling Heights, MI 48313
Phone
(586) 685-3285
NPI assigned
Mar 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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 CM005015 MI Primary

Addresses

Primary practice location

14460 Lakeside Circle
100
Sterling Heights, MI 48313

Mailing address

14460 Lakeside Cir
Sterling Heights, MI 48313-1348
Phone (586) 685-3285

Other identifiers 1

IdentifierTypeStateIssuer
CM005015OtherMISTATE LICENCE NUMBER

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
I20080530000557 MI Practitioner - Physician Assistant 3274603402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard a Stone MD PLLCGroup PAC ID 1355353749, 3 clinicians

Practice addresses (Care Compare)

14460 Lakeside Cir
Suite 100
Sterling Heights, MI 48313-1345
Phone (586) 685-3285

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CM005015MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Jul 1, 2013 Accepting new patients
Michigan Healthcare Professionals, P.C. CurrentSince Jul 1, 2013 Accepting new patients

Locations

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

27301 Dequindre Rd
Ste 209
Madison Hts, MI 48071
Phone (248) 541-1500

Organizations & group practices 4

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": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1467624023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14460 LAKESIDE CIR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131348",
            "telephone_number": "586-685-3285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14460 LAKESIDE CIRCLE",
            "address_2": "100",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48313",
            "telephone_number": "586-685-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINGSTON",
        "first_name": "COLLEEN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "CM005015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE NUMBER",
            "identifier": "CM005015",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.