NPIMap

Organization Active NPI

Bay Pointe Medical Center, PC

  • Primary Care Clinic/Center
  • Chesterfield, MI
National Provider Identifier
1629215769
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
4301074972 Issued in MI
Legal business name
BAY POINTE MEDICAL CENTER, PC
Practice address
32740 23 Mile Rd
Chesterfield, MI 48047-1978
Phone
(586) 725-7686
NPI assigned
Jan 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Authorized official

Name
Dr. Jacqueline Ann Pradko, MDNPI 1871568204
Title
President
Phone
(586) 725-7686

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 4301074972 MI Primary
Primary Care Clinic/Center 261QP2300X 4301060263 MI

Addresses

Primary practice location

32740 23 Mile Rd
Chesterfield, MI 48047-1978

Mailing address

32740 23 Mile Rd
Chesterfield, MI 48047-1978
Phone (586) 725-7686

Other identifiers 5

IdentifierTypeStateIssuer
0805017681OtherBLUE CROSS BLUE SHIELD PIN
1871568204OtherNPI JACQUELINE PRADKO MD
1770558769OtherNPI JAMES PRADKO MD
P00230505OtherMEDICARE RAILROAD
0805009052OtherBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1629215769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32740 23 MILE RD",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480471978",
            "telephone_number": "586-725-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32740 23 MILE RD",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480471978",
            "telephone_number": "586-725-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY POINTE MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "PRADKO",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-725-7686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301074972",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301060263",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PIN",
            "identifier": "0805017681",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI JACQUELINE PRADKO MD",
            "identifier": "1871568204",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI JAMES PRADKO MD",
            "identifier": "1770558769",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00230505",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0805009052",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.