Individual provider Active NPI

Maria Lambrene Oldenkamp, PA-C

  • Physician Assistant
  • Warren, MI
National Provider Identifier
1891240701
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone
(586) 573-5000
NPI assigned
Aug 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 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 MI Primary

Addresses

Primary practice location

11800 E 12 Mile Rd
Warren, MI 48093-3472

Mailing address

11800 E 12 Mile Rd
Warren, MI 48093-3472

Other names 1

  • Maria Lambrene Seremetis Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161011000369 MI Practitioner - Physician Assistant 7810285665 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Macomb Oakland Hospital Physician Assistant CurrentSince Feb 1, 2018 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Feb 1, 2018 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Feb 1, 2018 Accepting new patients

Locations

15959 Hall Rd
Ste 104
Macomb, MI 48044
Phone (586) 884-2688

27483 Dequindre Rd
Ste 204
Madison Hts, MI 48071
Phone (248) 967-7326

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: moldenkamp1143371@direct.hfhs.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1891240701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDENKAMP",
        "first_name": "MARIA",
        "middle_name": "LAMBRENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-20",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "SEREMETIS",
            "middle_name": "LAMBRENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.