Active NPI
Pranjali S Wakade, PA
- Physician Assistant
- Flint, MI
National Provider Identifier
1912056896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601002868
- Practice address
- 401 S Ballenger Hwy
Flint, MI 48532-3638 - Phone
- (810) 720-0639
- Fax
- (810) 230-1978
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601002868 | MI | Primary |
Addresses
Primary practice location
401 S Ballenger Hwy
Flint, MI 48532-3638
Mailing address
PO Box 321068
Flint, MI 48532-0019
Phone (810) 720-0639
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1036162 | Other | MI | NCCPA |
| 5601002868 | Other | MI | LICENSE |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- pwakade1156811@direct.hfhs.org
Organizations & group practices 1
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.
-
- Infectious Disease Physician
- Flint, MI
- NPI 1487731287
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461283200000",
"number": "1912056896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 321068",
"city": "FLINT",
"state": "MI",
"postal_code": "485320019",
"telephone_number": "810-720-0639",
"fax_number": "810-230-1978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 S BALLENGER HWY",
"city": "FLINT",
"state": "MI",
"postal_code": "485323638",
"telephone_number": "810-720-0639",
"fax_number": "810-230-1978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKADE",
"first_name": "PRANJALI",
"middle_name": "S",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-09",
"last_updated": "2016-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601002868",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCCPA",
"identifier": "1036162",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "5601002868",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
- Lisa Louise Wagner, MA, CCC-A
- Megan Wagner
- Shekinah Wagner
- Mallory Jean Waisanen, CCC-SLP
- Jamila Kesi Waits, BS,CAC-1
- Wal-Mart Stores East LP (Walmart Pharmacy 10-1928)
- Wal-Mart Stores East, LP (Vision Center 30-1928)
- Wal-Mart Stores East, LP (Vision Center 30-2273)
- Eva Wald, LLMSW
- Katrina Waldren, LPN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.