Pac Med PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PAC MED PLLC

Practice address

33300 Utica Rd
Fraser, MI 48026-2097

Phone

(248) 410-6398

NPI assigned

Apr 17, 2024

Organization subpart

No

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

Authorized official

Name

Anthony Konja, MDNPI 1639673601

Title

Owner

Phone

(248) 410-6398

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anthony Thayer Konja, DO

  • Internal Medicine Physician
  • Warren, MI
  • NPI 1639673601
  Medicare reassignment Authorized official
• Khaled Mostafa Ismail, M.D.

  • Nephrology Physician
  • Livonia, MI
  • NPI 1467674895
  Medicare reassignment
• Christie Ann Schunemann, FNP

  • Family Nurse Practitioner
  • Roseville, MI
  • NPI 1013909001
  Medicare reassignment

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1861246522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 CHERRY HILL DR",
            "city": "ORCHARD LAKE",
            "state": "MI",
            "postal_code": "483231611",
            "telephone_number": "248-410-6398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33300 UTICA RD",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480262097",
            "telephone_number": "248-410-6398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAC MED PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "KONJA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-410-6398",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Nouhan, MD
• Keith David Nowicki, DDS
• Oakland Psychological Clinic, P.C.
• Occupational Health Centers of Michigan, P.C.
• Laurel Oja
• Yulonda Pack
• Manit Pahuja, FNP-C
• Jeffin Panicker, PHARMD
• Alaina Parker
• Paul R Troost DO PC

• Internal Medicine Physician in Fraser, MI
• Providers in Fraser, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.