Individual provider Active NPI

Navin C Pancholy, MD

  • Surgery Physician
  • Three Rivers, MI
National Provider Identifier
1700978509
Registry record updated May 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
42880 Issued in WA
Practice address
715 S Health Pkwy
Three Rivers Health
Three Rivers, MI 49093-8352
Phone
(269) 273-8471
Fax
(269) 273-9680
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 42880 WA Primary

Addresses

Primary practice location

715 S Health Pkwy
Three Rivers Health
Three Rivers, MI 49093-8352

Mailing address

715 S Health Pkwy
Three Rivers, MI 49093-8352
Phone (269) 273-8471

Other identifiers 1

IdentifierTypeStateIssuer
8374423MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42880WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinton Memorial Hospital of Wilmington Clinton County Ohio Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243555200000",
    "number": "1700978509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 S HEALTH PKWY",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938352",
            "telephone_number": "269-273-8471",
            "fax_number": "269-273-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S HEALTH PKWY",
            "address_2": "THREE RIVERS HEALTH",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938352",
            "telephone_number": "269-273-8471",
            "fax_number": "269-273-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCHOLY",
        "first_name": "NAVIN",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2009-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "42880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8374423",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Three Rivers, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.