Patrick Agunwa, PA
Individual provider Active NPI Physician Assistant · West Bloomfield, MI
NPI 1912321027 · NPPES record last updated Mar 15, 2023
Key facts
- NPI
- 1912321027
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601006923 (MI)
- Practice address
- 6777 W Maple Rd
West Bloomfield, MI 48322-3013 - Phone
- (800) 653-6568
- NPI assigned
- Feb 10, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Michigan Infusion Services and Licensed Healthcare
Henry Ford Health System
Practice addresses (Care Compare)
1056 N Holbrook St
Plymouth, MI 48170-1410
Phone (734) 341-7767
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
500 Ross St
Plymouth, MI 48170-2206
6777 W Maple Rd
Henry Ford West Bloomfield Med Ctr
West Bloomfield, MI 48322-3013
Phone (248) 661-4100
Hospital & facility affiliations
- Henry Ford Health West Bloomfield Hospital
- Henry Ford Health Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140627001592 | MI | Practitioner - Physician Assistant | 1658596010 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601006923 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health System | Current |
Accepting new patients | |
| Henry Ford Macomb Hospital Corporation | Physician Assistant | Current |
Accepting new patients |
| Henry Ford Health System | Physician Assistant | Current |
Accepting new patients |
| Henry Ford Macomb Hospital Corporation | Current |
Accepting new patients | |
| Blue Water Urgent Care PLLC | Past |
Accepting new patients |
Locations
15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800
1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255
6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000
Interoperability endpoints
- ms_pagunwa@landmarkhealth-direct.org
- pagunwa282879@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601006923 | ||
| Physician Assistant | 363A00000X | 5601006923 | MI | Yes |
Addresses
Primary practice location
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Mailing address
1 Ford PL Ste 3a
Detroit, MI 48202-3450
Other practice location 1
6301 Royal Point
West Bloomfield, MI 48322
Phone (248) 361-9085
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pagunwa1@hfhs.org |
Other providers in West Bloomfield, MI
- Carol Afflerbaugh
- Affordable Medical Equipment & Supply, Co., Inc.
- Asghar Afsari
- Deepika Aggarwal
- Kori Lynn Agius
- Ah West Bloomfield Subtenant, LLC
- Abraham K Aharoni
- Eleanor Aharoni
- Ahava Group LLC
- Ahava Home Care LLC
All providers in West Bloomfield, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.