Individual provider Active NPI

Bozena Waltenspiel, PA-C

  • Physician Assistant
  • Lapeer, MI
National Provider Identifier
1578718870
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1375 N Main St
Lapeer, MI 48446-1350
Phone
(810) 667-5574
Fax
(810) 667-5910
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

1375 N Main St
Lapeer, MI 48446-1350

Mailing address

3875 Andover Ave
Auburn Hills, MI 48326-3030
Phone (586) 243-7043

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
I20110222000851 MI Practitioner - Physician Assistant 7012198161 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jawad a Shah MD PCGroup PAC ID 5799779633, 89 clinicians

Practice addresses (Care Compare)

21230 Dequindre Rd
Warren, MI 48091-2279
Phone (810) 275-9333

4800 S Saginaw St
Flint, MI 48507-2677

5111 Auto Club Dr
Dearborn, MI 48126-2749
Phone 8102759333116

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jawad a Shah, MD PC CurrentSince May 1, 2023 Accepting new patients

Locations

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

4800 S Saginaw St
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1800
Flint, MI 48507
Phone (810) 732-8336

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.

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": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1578718870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3875 ANDOVER AVE",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483263030",
            "telephone_number": "586-243-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 N MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461350",
            "telephone_number": "810-667-5574",
            "fax_number": "810-667-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTENSPIEL",
        "first_name": "BOZENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

Verify at the official NPI Registry.