Paul D Croissant, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

4301029245 Issued in MI

Practice address

44555 Woodward Ave Ste 307
Pontiac, MI 48341-5035

Phone

(248) 484-5303

Fax

(488) 585-8692

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1699754754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE STE 307",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415035",
            "telephone_number": "248-484-5303",
            "fax_number": "488-585-8692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE STE 307",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415035",
            "telephone_number": "248-484-5303",
            "fax_number": "488-585-8692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROISSANT",
        "first_name": "PAUL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301029245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS OF MICHIGAN",
            "identifier": "01008146",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "700F318300",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLANS",
            "identifier": "B44980",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00331429",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0636905",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "C4370",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH PLANS",
            "identifier": "0004459938",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104851988",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699754754",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICES",
            "identifier": "101507",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ATHENA",
            "affiliation": "N",
            "address_1": "44555 Woodward Ave Ste 307",
            "city": "Pontiac",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483415035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nikkole Machelle Crane
• Mary A Crawford
• Toye L Crawford
• Alisa Cretu
• Susan Crim
• Antwan Croom
• Ashley Crowder, MA, LLPC
• Carly Elizabeth Crull
• Wendy R Crusoe
• Mariela Cruz Rodriguez

• Neurological Surgery Physician in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Neurological Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.