NPIMap

Individual provider Active NPI

Heather M Kathawa, PAC

  • Physician Assistant
  • Dearborn, MI
National Provider Identifier
1689913410
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006579 Issued in MI
Practice address
18101 Oakwood Blvd
Emergency Dept
Dearborn, MI 48124-4089
Phone
(313) 593-8780
Fax
(313) 436-2864
NPI assigned
Feb 14, 2013
Last updated
May 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

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 5601006579 MI Primary

Addresses

Primary practice location

18101 Oakwood Blvd
Emergency Dept
Dearborn, MI 48124-4089

Mailing address

265 Brookview Centre Way
Suite 400
Knoxville, TN 37919-4049
Phone (800) 342-2898

Other identifiers 1

IdentifierTypeStateIssuer
12501261OtherMICAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130315000235 MI Practitioner - Physician Assistant 1658516935 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southfield City Urgent Care PCGroup PAC ID 5698948354, 22 clinicians
Oak Park Urgent Care PLLCGroup PAC ID 6305169988, 23 clinicians
Hoover Urgent Care of Warren PLLCGroup PAC ID 6204073752, 38 clinicians

Practice addresses (Care Compare)

23832 Southfield Rd
Southfield, MI 48075-8000
Phone (248) 569-2600

24661 Coolidge Hwy
Oak Park, MI 48237-1449
Phone (248) 398-4000

26000 Hoover Rd
Warren, MI 48089-1167
Phone (586) 722-0707

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals, P.C. CurrentSince Aug 19, 2013 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Aug 19, 2013 Accepting new patients
Garg and Associates Inc Past Accepting new patients

Locations

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

Interoperability endpoints

  • Direct secure messaging: hkathawa1134225@direct.hfhs.org

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1689913410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 BROOKVIEW CENTRE WAY",
            "address_2": "SUITE 400",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194049",
            "telephone_number": "800-342-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "address_2": "EMERGENCY DEPT",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-8780",
            "fax_number": "313-436-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATHAWA",
        "first_name": "HEATHER",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-14",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12501261",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.