Individual provider Active NPI

Frazer A Wadenstorer, M.D.

  • Pulmonary Disease Physician
  • Flint, MI
National Provider Identifier
1861492167
Registry record updated Nov 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
4301043067 Issued in MI
Practice address
G3252 Beecher Rd
Flint, MI 48532-3614
Phone
(810) 230-6800
Fax
(810) 230-0713
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 4301043067 MI Primary

Addresses

Primary practice location

G3252 Beecher Rd
Flint, MI 48532-3614

Mailing address

G3252 Beecher Rd
Flint, MI 48532-3614
Phone (810) 230-6800

Other identifiers 1

IdentifierTypeStateIssuer
1661406MedicaidMI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100115000181 MI Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7416854203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Wayne State University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary Associates, PCGroup PAC ID 7719984194, 11 clinicians

Practice addresses (Care Compare)

G3252 Beecher Rd
Flint, MI 48532-3614
Phone (810) 230-6800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301043067MIMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hurley Medical Center CurrentSince Dec 6, 2016 Accepting new patients
Hurley Medical Center Current Accepting new patients
Pulmonary Associates, PC Pulmonary Disease CurrentSince Mar 7, 1996 Accepting new patients
Hurley Medical Center CurrentSince Dec 6, 2016 Accepting new patients
McLaren Flint PastSince Oct 10, 2014 Accepting new patients

Locations

G3252 Beecher Rd
Flint, MI 48532
Phone (810) 230-6800

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

8401 Holly Rd
Grand Blanc, MI 48439
Phone (810) 695-8011

Interoperability endpoints

  • Direct secure messaging: frazerwadenstorer@papc.allscriptsdirect.net

Organizations & group practices 5

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 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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258070400000",
    "number": "1861492167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G3252 BEECHER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323614",
            "telephone_number": "810-230-6800",
            "fax_number": "810-230-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G3252 BEECHER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323614",
            "telephone_number": "810-230-6800",
            "fax_number": "810-230-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADENSTORER",
        "first_name": "FRAZER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2009-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301043067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1661406",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.