NPIMap

Individual provider Active NPI

Paul Penfold, P.A.-C

  • Physician Assistant
  • Caseville, MI
National Provider Identifier
1871537829
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003455 Issued in MI
Practice address
7000 Main St
Caseville, MI 48755
Phone
(989) 856-3446
Fax
(989) 856-2209
NPI assigned
Jun 16, 2006
Last updated
Mar 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 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 5601003455 MI Primary

Addresses

Primary practice location

7000 Main St
Caseville, MI 48755

Mailing address

7000 Main St
Caseville, MI 48725-5112
Phone (989) 856-3449

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ppenfold45572@direct.covenanthealthcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050203000360 MI Practitioner - Physician Assistant 6103877469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scheurer HospitalGroup PAC ID 1456242296, 49 clinicians

Practice addresses (Care Compare)

7000 Main St
Caseville, MI 48725-5112
Phone (989) 856-3449

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601003455MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scheurer Hospital CurrentSince Apr 9, 2012 Accepting new patients
Scheurer Hospital CurrentSince Apr 9, 2012 Accepting new patients
Scheurer Hospital Past Accepting new patients
Scheurer Hospital Past Accepting new patients
Scheurer Hospital Past Accepting new patients

Locations

168 N Caseville Rd
Pigeon, MI 48755
Phone (989) 453-2141

57 S Center St
Sebewaing, MI 48759
Phone (989) 883-9656

Interoperability endpoints

  • Direct secure messaging: ppenfold45572@direct.covenanthealthcare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1871537829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 MAIN ST",
            "city": "CASEVILLE",
            "state": "MI",
            "postal_code": "487255112",
            "telephone_number": "989-856-3449",
            "fax_number": "989-856-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 MAIN ST",
            "city": "CASEVILLE",
            "state": "MI",
            "postal_code": "48755",
            "telephone_number": "989-856-3446",
            "fax_number": "989-856-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENFOLD",
        "first_name": "PAUL",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppenfold45572@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "7000 Main St",
            "city": "Caseville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "487255112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Caseville, MI

Sources for this page

Verify at the official NPI Registry.