Active NPI
Pravin N Soni, M.D.
- Psychiatry Physician
- Mount Clemens, MI
National Provider Identifier
1508812488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 1508812488
- Practice address
- 279 N Groesbeck Hwy
Mount Clemens, MI 48043-1546 - Phone
- (586) 627-0024
- Fax
- (586) 627-0027
- NPI assigned
- May 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 1508812488 | MI | Primary |
Addresses
Primary practice location
279 N Groesbeck Hwy
Mount Clemens, MI 48043-1546
Mailing address
2030 Birchwood Way
Bloomfield Hills, MI 48302-1600
Phone (586) 627-0024
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4672851 10 | Medicaid | MI | |
| 4672842 10 | Medicaid | MI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1508812488 | MI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alternative Community Living, Inc. | Past | Accepting new patients | |
| Alternative Community Living Inc | Past | Accepting new patients | |
| Access Ipa | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Dearborn, MI
- NPI 1760682371
-
dba New Passges
- Adult Mental Health Clinic/Center
- Mount Clemens, MI
- NPI 1396953378
-
dba Hope Network - New Passages
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Saginaw, MI
- NPI 1487008652
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398038400000",
"number": "1508812488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2030 BIRCHWOOD WAY",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483021600",
"telephone_number": "586-627-0024",
"fax_number": "586-627-0027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "279 N GROESBECK HWY",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480431546",
"telephone_number": "586-627-0024",
"fax_number": "586-627-0027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONI",
"first_name": "PRAVIN",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2014-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "1508812488",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4672851 10",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4672842 10",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Clemens, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.