Individual provider Active NPI

Juliann Pallikizhakethil

  • Physician Assistant
  • Northville, MI
National Provider Identifier
1881133759
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
38646 Wakefield CT
Northville, MI 48167-8957
Phone
(248) 974-2903
NPI assigned
Feb 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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 Primary

Addresses

Primary practice location

38646 Wakefield CT
Northville, MI 48167-8957

Mailing address

38646 Wakefield CT
Northville, MI 48167-8957
Phone (248) 974-2903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20211228002126 CA Practitioner - Physician Assistant 4385044387 Reassigns benefits to 1 organization
I20220523001818 IL Practitioner - Physician Assistant 4385044387
I20231011002433 NY Practitioner - Physician Assistant 4385044387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians
Ophelia Medical Group Ca PCGroup PAC ID 5294126587, 4 clinicians

Practice addresses (Care Compare)

18 E 41St St
FL 14
New York, NY 10017-6244
Phone (215) 585-2144

6920 Miramar Rd
Suite 329
San Diego, CA 92121-2642
Phone (215) 585-2144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56463CAMDPharmacist
020673NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Workit Health Mi PLLC CurrentSince May 4, 2022 Accepting new patients
Ophelia Medical Group FL, P.a. CurrentSince Oct 23, 2023 Accepting new patients
Workit Health Mi PLLC CurrentSince May 4, 2022 Accepting new patients

Locations

1280 Iroquois Ave
Ste 402
Naperville, IL 60563
Phone (872) 255-0357

3300 Washtenaw Ave
Ste 280
Ann Arbor, MI 48104
Phone (734) 329-5419

18 E 41st St
Fl 14
New York, NY 10017
Phone (305) 395-4313

228 Park Ave S
New York, NY 10003
Phone (215) 588-2144

527 Bay Rd
Ste 7
Queensbury, NY 12804
Phone (212) 585-2144

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1881133759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38646 WAKEFIELD CT",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481678957",
            "telephone_number": "248-974-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38646 WAKEFIELD CT",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481678957",
            "telephone_number": "248-974-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLIKIZHAKETHIL",
        "first_name": "JULIANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

Verify at the official NPI Registry.