Laura Jean Balavitch-Gomez, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601001632 Issued in MI

Practice address

36549 Harper Ave
Suite B
Clinton TWP, MI 48035-2012

Phone

(586) 791-3150

Fax

(586) 791-0409

NPI assigned

May 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Albert a. Przybylski, D.O, PC

  • Family Medicine Physician
  • Clinton TWP, MI
  • NPI 1487826020
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891901278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36549 HARPER AVE",
            "address_2": "SUITE B",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480352012",
            "telephone_number": "586-791-3150",
            "fax_number": "586-791-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36549 HARPER AVE",
            "address_2": "SUITE B",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480352012",
            "telephone_number": "586-791-3150",
            "fax_number": "586-791-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALAVITCH-GOMEZ",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601001632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baek & Weeden Medical & Sports Supplies
• Charlene Bailey, P.A. C.
• Phylicia Bailey
• Baker & Ochs, P.C.
• Susan A Baker-Ochs, DDS
• Anthony Frank Balcerzak, OWNER
• Janet Patrice Baldwin, OTR
• Janet Banks-McElrath, RN, MA
• Melissa Barilka
• Stacy Lynn Barnes

• Medical Physician Assistant in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.