Individual provider Active NPI

Emily A Balten, PAC

  • Physician Assistant
  • West Bloomfield, MI
National Provider Identifier
1770895799
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005789 Issued in MI
Practice address
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone
(248) 325-1000
Fax
(248) 325-0623
NPI assigned
Jul 7, 2010
Last updated
Mar 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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 5601005789 MI Primary

Addresses

Primary practice location

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Mailing address

8401 Cherry Hill Rd
Ypsilanti, MI 48198-9425
Phone (248) 494-1484

Other identifiers 2

IdentifierTypeStateIssuer
12131237OtherCAQH
5820835OtherMIBCBSMI

Other names 1

  • Emily A Kawada Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ebalten58110@direct.hfhs.org

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101109000311 MI Practitioner - Physician Assistant 3779778345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

6777 W Maple Rd
Henry Ford West Bloomfield Med Ctr
West Bloomfield, MI 48322-3013
Phone (248) 661-4100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Physician Assistant CurrentSince Oct 22, 2012 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System CurrentSince Oct 22, 2012 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Organizations & group practices 4

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 1

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": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1770895799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 CHERRY HILL RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481989425",
            "telephone_number": "248-494-1484",
            "fax_number": "248-325-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "248-325-1000",
            "fax_number": "248-325-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTEN",
        "first_name": "EMILY",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12131237",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMI",
            "identifier": "5820835",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebalten58110@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "6777 W Maple Rd",
            "city": "West Bloomfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483223013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "KAWADA",
            "middle_name": "A",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.