Individual provider Active NPI

Madeline Ann Paquette, DNP, FNP-C

  • Nurse Practitioner
  • West Bloomfield, MI
National Provider Identifier
1538825542
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704337296 Issued in MI
Practice address
2300 Haggerty Rd Ste 1190
West Bloomfield, MI 48323-2188
Phone
(248) 624-9800
NPI assigned
Nov 14, 2021
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704337296 MI
Nurse Practitioner 363L00000X 4704337296 MI Primary

Addresses

Primary practice location

2300 Haggerty Rd Ste 1190
West Bloomfield, MI 48323-2188

Mailing address

2300 Haggerty Rd Ste 1190
West Bloomfield, MI 48323-2188
Phone (248) 624-9800

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
I20220311000908 MI Practitioner - Nurse Practitioner 3274928106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Vein Therapies PLLCGroup PAC ID 5496750523, 9 clinicians

Practice addresses (Care Compare)

22731 Newman
250 Miller Vein
Dearborn, MI 48124-2034
Phone (248) 344-9110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1636848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1538825542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD STE 1190",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232188",
            "telephone_number": "248-624-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD STE 1190",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232188",
            "telephone_number": "248-624-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUETTE",
        "first_name": "MADELINE",
        "middle_name": "ANN",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-14",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704337296",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704337296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.