Wayne Pediatrics Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

WAYNE PEDIATRICS INC.

Practice address

400 Mack Ave
Detroit, MI 48201-2136

Phone

(313) 577-5437

NPI assigned

Feb 19, 2020

Last updated

Feb 19, 2020By 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

Dr. Herman Gray, MD

Title

President

Phone

(313) 577-3231

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 12

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.

• Colleen Buggs - Saxton, M.D.

  • Pediatric Endocrinology Physician
  • Detroit, MI
  • NPI 1750337135
  Medicare reassignment Care Compare group NPD
• Cristina Cotronei-Cascardo, MD

  • Allergy Physician
  • Detroit, MI
  • NPI 1275550287
  Medicare reassignment Care Compare group NPD
• Sharon Philippa Marshall, MD

  • Pediatric Adolescent Medicine Physician
  • Detroit, MI
  • NPI 1659319770

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Gabriella Geiszt, MD

  • Psychiatry Physician
  • Detroit, MI
  • NPI 1679633549
  Medicare reassignment NPD
• Eric J McGrath, M.D.

  • Pediatric Infectious Diseases Physician
  • Detroit, MI
  • NPI 1588866404

  Pediatrics

  Medicare reassignment NPD
• Kumba Njie, M.D

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1235661083
  Medicare reassignment NPD
• Lynn Cameron Smitherman, MD

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1609814722
  Medicare reassignment NPD
• Christopher A Youngman, MD

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1740360890
  Medicare reassignment NPD
• Laura J Benjamins, MD, MPH

  • Pediatric Adolescent Medicine Physician
  • Houston, TX
  • NPI 1528272028

  MI, Pediatrics

  Medicare reassignment NPD
• Eric W Ayers, MD

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1407893118

  Pediatrics

  NPD
• Salome Cockern, PHDWQ2

  • Psychologist
  • Detroit, MI
  • NPI 1164179321
  NPD
• Dena Hisham Nazer, M.D.

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1962675074
  NPD (past)

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1760015622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 KIRBY, 4249 F.A.B.",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136",
            "telephone_number": "313-577-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE PEDIATRICS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "HERMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-577-3231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne County Jail
• Wayne County Jail Pharmacy
• Wayne County Juvenile Detention Facility
• Wayne County Patient Care Management System
• Wayne J Joseph, D.D.S.,Ms,PC
• Wayne Physician Services PC
• Wayne State University
• Wayne State University
• Wayne State University
• Wayne State University Psychology Clinic

• Pediatrics Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.