Individual provider Active NPI

Monica Nicola, MD

  • Internal Medicine Physician
  • Pontiac, MI
National Provider Identifier
1477522357
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MN077426 Issued in MI
Practice address
44405 Woodward Ave
Pontiac, MI 48341-5023
Phone
(248) 858-3126
Fax
(248) 858-6499
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MN077426 MI Primary

Addresses

Primary practice location

44405 Woodward Ave
Pontiac, MI 48341-5023

Mailing address

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-3126

Other identifiers 1

IdentifierTypeStateIssuer
4741485MedicaidMI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050720000537 MI Practitioner - Internal Medicine 1153358239 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MN077426MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Wellness Plan Medical Centers CurrentSince Jul 7, 2014 Accepting new patients
The Wellness Plan Medical Centers Current Accepting new patients
The Wellness Plan Medical Centers CurrentSince Jul 7, 2014 Accepting new patients

Locations

21040 Greenfield Rd
Oak Park, MI 48237
Phone (248) 967-1888

44405 Woodward Ave
#H13
Pontiac, MI 48341
Phone (248) 858-3787

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCBDCD

Organizations & group practices 3

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1477522357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-3126",
            "fax_number": "248-858-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-3126",
            "fax_number": "248-858-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLA",
        "first_name": "MONICA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "MN077426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4741485",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.