Pavadee Poowuttikul, M.D.

Primary specialty

Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X

License

4301090387 Issued in MI

Practice address

3950 Beaubien - 3Rd FL
Childrens Hospital of Mi
Detroit, MI 48201-2119

Phone

(313) 832-8550

Fax

(313) 993-8685

NPI assigned

Nov 14, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University PediatriciansGroup PAC ID 9638070568, 121 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Children's Hospital of Michigan Hospital, Detroit, MI, CCN 233300

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ppoowutt@direct.dmc.org

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.

• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1811920549
  Medicare reassignment Care Compare group NPD
• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1184471690
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• VHS Childrens Hospital of Michigan Inc

  dba Childrens Hospital of Michigan

  • Children's Hospital
  • Detroit, MI
  • NPI 1538471800
  Care Compare affiliation

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1952582314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 ST. ANTOINE - UHC 5D MAILBOX 226",
            "address_2": "UNIVERSITY PEDIATRICIANS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4405",
            "fax_number": "313-966-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 BEAUBIEN - 3RD FL",
            "address_2": "CHILDRENS HOSPITAL OF MI",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-832-8550",
            "fax_number": "313-993-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOWUTTIKUL",
        "first_name": "PAVADEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301090387",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "MI",
            "license": "4301090387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prathvi Poojary, D.D.S.
• Diana Pool, MA,MS, RSST, CHW
• Akeista Marie Poole
• Kelsey Poole, BSN, RDN, BFPC, CHW
• Pavi Elle Shanell Poole
• Ligia M. Pop, M.D.
• Lilia Popadiuk, P.A.
• Alexis S Pope, LLBSW
• Andrea Pope, LPN
• Diana Pope, R.S.S.T.

• Pediatric Allergy/Immunology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Pediatric Allergy/Immunology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.