Individual provider Active NPI

John Kay Nwadinobi, PA

  • Medical Physician Assistant
  • Southfield, MI
National Provider Identifier
1790766509
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601004533 Issued in MI
Practice address
29610 Southfield Rd
Ste 250
Southfield, MI 48076-2000
Phone
(248) 234-8912
Fax
(248) 234-8988
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601004533 MI Primary

Addresses

Primary practice location

29610 Southfield Rd
Ste 250
Southfield, MI 48076-2000

Mailing address

29610 Southfield Rd
Ste 250
Southfield, MI 48076-2000
Phone (583) 573-6400

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
I20060214000571 MI Practitioner - Physician Assistant 5496760308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

29610 Southfield Rd
Southfield, MI 48076-2000
Phone (248) 234-8912

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
John Kay Nwadinobi CurrentSince Jan 1, 1990 Accepting new patients
Home Visiting Group,Inc Past Accepting new patients

Organizations & group practices 3

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1790766509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29610 SOUTHFIELD RD",
            "address_2": "STE 250",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762000",
            "telephone_number": "583-573-6400",
            "fax_number": "586-576-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29610 SOUTHFIELD RD",
            "address_2": "STE 250",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762000",
            "telephone_number": "248-234-8912",
            "fax_number": "248-234-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWADINOBI",
        "first_name": "JOHN",
        "middle_name": "KAY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.