Individual provider Active NPI

Karlee Pattullo, PA

  • Physician Assistant
  • Oxford, MI
National Provider Identifier
1841859196
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009509 Issued in MI
Practice address
385 N Lapeer Rd
Oxford, MI 48371-3610
Phone
(248) 969-7354
Fax
(248) 628-8802
NPI assigned
Jun 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 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 5601009509 MI Primary

Addresses

Primary practice location

385 N Lapeer Rd
Oxford, MI 48371-3610

Mailing address

385 N Lapeer Rd
Oxford, MI 48371-3610
Phone (248) 969-7354

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
I20190725000990 MI Practitioner - Physician Assistant 9931435195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McLaren OaklandGroup PAC ID 0547173213, 51 clinicians

Practice addresses (Care Compare)

180 N Ortonville Rd
Ortonville, MI 48462-8575
Phone (248) 627-3535

50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 338-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601009509MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Oakland CurrentSince Jul 16, 2019 Accepting new patients
McLaren Oakland Current Accepting new patients
McLaren Oakland Physician Assistant CurrentSince Jul 16, 2019 Accepting new patients

Locations

8172 Reliable Pkwy
Chicago, IL 60686
Phone (517) 908-0847

180 N Ortonville Rd
Ortonville, MI 48462
Phone (248) 627-3535

385 N Lapeer Rd
Oxford, MI 48371
Phone (248) 628-2597

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

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.

Hospital & facility affiliations 4

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": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1841859196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 N LAPEER RD",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483713610",
            "telephone_number": "248-969-7354",
            "fax_number": "248-628-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 N LAPEER RD",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483713610",
            "telephone_number": "248-969-7354",
            "fax_number": "248-628-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTULLO",
        "first_name": "KARLEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MI

Sources for this page

Verify at the official NPI Registry.