Organization Active NPI

Priti Bhardwaj MD PC

  • Internal Medicine Physician
  • Taylor, MI
National Provider Identifier
1851447692
Registry record updated Oct 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301069863 Issued in MI
Legal business name
PRITI BHARDWAJ MD PC
Practice address
25420 Goddard Rd
Taylor, MI 48180-6200
Phone
(313) 299-8006
Fax
(313) 299-8009
NPI assigned
Jan 26, 2007
Last updated
Oct 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2011

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

Authorized official

Name
Priti Bhardwaj, MDNPI 1205879434
Title
Office Manager
Phone
(313) 388-1666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 4301069863 MI Primary

Addresses

Primary practice location

25420 Goddard Rd
Taylor, MI 48180-6200

Mailing address

25420 Goddard Rd
Taylor, MI 48180-6200
Phone (313) 299-8006

Other identifiers 1

IdentifierTypeStateIssuer
104332410MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040927000468 MI Part B Supplier - Clinic/Group Practice 1052380185 Receives reassigned benefits from 13 practitioners
Practice locations: Lincoln Park, MI; Taylor, MI

National Provider Directory

National Provider Directory

Locations

1704 Papalas Dr
Lincoln Park, MI 48146
Phone (313) 389-0100

28588 Northwestern Hwy
Southfield, MI 48034
Phone (248) 357-7766

21611 E 11 Mile Rd
St Clr Shores, MI 48081
Phone (586) 771-7200

20500 Eureka Rd
Ste 211
Taylor, MI 48180
Phone (734) 283-5643

10882 Beech Daly Rd
Taylor, MI 48180
Phone (313) 291-2782

25420 Goddard Rd
Taylor, MI 48180
Phone (313) 299-7243

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JIHFBA

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1851447692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25420 GODDARD RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806200",
            "telephone_number": "313-299-8006",
            "fax_number": "313-299-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25420 GODDARD RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806200",
            "telephone_number": "313-299-8006",
            "fax_number": "313-299-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRITI BHARDWAJ MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "BHARDWAJ",
        "authorized_official_first_name": "PRITI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "313-388-1666",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301069863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104332410",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.