Kim Abbegail Tan Aldecoa

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

St. Joseph Mercy Oakland Hospital,44405 Woodward Avenue
Medical Education Department H23
Pontiac, MI 48341

Phone

(248) 858-6233

Fax

(248) 858-3244

NPI assigned

Jun 21, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1700517778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ST. JOSEPH MERCY OAKLAND HOSPITAL,44405 WOODWARD AVENUE",
            "address_2": "MEDICAL EDUCATION DEPARTMENT H23",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48341",
            "telephone_number": "248-858-6233",
            "fax_number": "248-858-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST. JOSEPH MERCY OAKLAND HOSPITAL,44405 WOODWARD AVENUE",
            "address_2": "MEDICAL EDUCATION DEPARTMENT H23",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48341",
            "telephone_number": "248-858-6233",
            "fax_number": "248-858-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALDECOA",
        "first_name": "KIM ABBEGAIL",
        "middle_name": "TAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dilnaz Alam, MD
• Zahra Alami, M.D.
• Gayl Jean Alasina, NNP
• Kristen Albright
• Gayle Marie Albritton, NP
• Zoha Abdul Aleem, MD
• Erika Alexander, MA, LPC, CAC
• Humza Rehman Ali, DO
• Ijaz Ali, PHYSICIAN, M.D
• Janice A Alias

• Student in an Organized Health Care Education/Training Program in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.