Michigan Pediatric ENT Associates, PLLC

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

License

4301085240 Issued in MI

Legal business name

MICHIGAN PEDIATRIC ENT ASSOCIATES, PLLC

Practice address

7001 Orchard Lake Rd
Suite 320C
West Bloomfield, MI 48322-3604

Phone

(248) 571-3600

Fax

(248) 973-8560

NPI assigned

Dec 5, 2006

Last updated

May 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lynn Denhardt

Title

Practice Manager

Phone

(248) 847-3210

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 7

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.

• Michael S Haupert, DO

  • Pediatric Otolaryngology Physician
  • West Bloomfield, MI
  • NPI 1124018213
  Medicare reassignment
• Lindsay Ann Ruwart, NP-C

  • Nurse Practitioner
  • Royal Oak, MI
  • NPI 1679002091
  Medicare reassignment
• Prasad J Thottam, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • West Bloomfield, MI
  • NPI 1851720312
  Medicare reassignment
• Alyssa Morici

  • Pediatric Nurse Practitioner
  • West Bloomfield, MI
  • NPI 1013877836
  NPD (past)
• Jay Szekely

  • Facial Plastic Surgery Physician
  • Commerce Township, MI
  • NPI 1417349713
  NPD (past)
• Ivanna Yau, NP

  • Nurse Practitioner
  • West Bloomfields, MI
  • NPI 1467263152
  NPD (past)
• Kathryn Deeds, MD

  • Otolaryngology Physician
  • Pittsburgh, PA
  • NPI 1164985792
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1679631360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 ORCHARD LAKE RD",
            "address_2": "SUITE 320C",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223604",
            "telephone_number": "248-571-3600",
            "fax_number": "248-973-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 ORCHARD LAKE RD",
            "address_2": "SUITE 320C",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223604",
            "telephone_number": "248-571-3600",
            "fax_number": "248-973-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN PEDIATRIC ENT ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "DENHARDT",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "248-847-3210",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MI",
            "license": "4301026037",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MI",
            "license": "5101010352",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MI",
            "license": "5101009481",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MI",
            "license": "4301085240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michigan Institute of Sleep Disorders PLLC
• Michigan Interventional Pain Associates PLLC
• Michigan Interventional Pain Associates PLLC
• Michigan Oms P C
• Michigan Orthopaedic Surgeons PLLC
• Michigan Radiology Services, P.C.
• Michigan Surgery Specialists P.C. (Motus Rehabilitation)
• Michigan Telemedicine Associates, P.C.
• Michigan Thoracic Institute, PC
• Michigan Womens Health Institute,PC

• Pediatric Otolaryngology Physician in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Pediatric Otolaryngology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.