Organization Active NPI

Mount Pleasant Medical Associates, PLLC

  • Family Medicine Physician
  • Mt Pleasant, MI
National Provider Identifier
1619372901
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301075001 Issued in MI
Legal business name
MOUNT PLEASANT MEDICAL ASSOCIATES, PLLC
Practice address
4639 E Pickard St
Suite B
Mount Pleasant, MI 48858-2077
Phone
(989) 817-4300
Fax
(989) 817-4301
NPI assigned
Oct 29, 2014
Last updated
Jan 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Dr. Nisha VashishtaNPI 1528008448
Title
Owner
Phone
(989) 400-6647

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 4301075001 MI Primary

Addresses

Primary practice location

4639 E Pickard St
Suite B
Mount Pleasant, MI 48858-2077

Mailing address

1420 Batson Dr
Mount Pleasant, MI 48858-4311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150326001345 MI Part B Supplier - Clinic/Group Practice 8729305958 Receives reassigned benefits from 3 practitioners
Practice locations: Mount Pleasant, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2091014Mount Pleasant Medical Associates PLLC4639 E Pickard Street Suite B, Mount Pleasant, MI 48858Certificate of waiverFeb 3, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1619372901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 BATSON DR",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488584311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4639 E PICKARD ST",
            "address_2": "SUITE B",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488582077",
            "telephone_number": "989-817-4300",
            "fax_number": "989-817-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT PLEASANT MEDICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-29",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "VASHISHTA",
        "authorized_official_first_name": "NISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-400-6647",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301075001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.