Individual provider Active NPI

Julie Christine Pfeifle, PA-C

  • Physician Assistant
  • Waterford, MI
National Provider Identifier
1588067904
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007190 Issued in MI
Practice address
2665 Elizabeth Lake Rd
Waterford, MI 48328-3277
Phone
(248) 681-9541
Fax
(248) 834-2001
NPI assigned
Sep 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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 5601007190 MI Primary

Addresses

Primary practice location

2665 Elizabeth Lake Rd
Waterford, MI 48328-3277

Mailing address

2665 Elizabeth Lake Rd
Waterford, MI 48328-3277
Phone (248) 681-9541

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
I20141027001271 MI Practitioner - Physician Assistant 0042431520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601007190MIMDPhysician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1588067904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 ELIZABETH LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283277",
            "telephone_number": "248-681-9541",
            "fax_number": "248-834-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 ELIZABETH LAKE RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283277",
            "telephone_number": "248-681-9541",
            "fax_number": "248-834-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFLE",
        "first_name": "JULIE",
        "middle_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.