Individual provider Active NPI

Kendyl Noel Pochmara, PA-C

  • Physician Assistant
  • Sterling Heights, MI
National Provider Identifier
1982113452
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
43455 Schoenherr Rd Ste 2
Sterling Heights, MI 48313-1972
Phone
(586) 726-4823
NPI assigned
Sep 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2017

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 Primary

Addresses

Primary practice location

43455 Schoenherr Rd Ste 2
Sterling Heights, MI 48313-1972

Mailing address

49397 Appaloosa Dr
Macomb, MI 48042-4730
Phone (586) 260-5919

Other names 1

  • Kendyl Noel Diederich 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
I20171115003467 MI Practitioner - Physician Assistant 3476819913 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Family Medicine Chesterfield PC PastSince Oct 6, 2009 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kpochmara496717@direct.hfhs.org
  • Direct secure messaging: kendylpochmara@spmgsh.allscriptsdirect.net

Organizations & group practices 2

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": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506470400000",
    "number": "1982113452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49397 APPALOOSA DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480424730",
            "telephone_number": "586-260-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43455 SCHOENHERR RD STE 2",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131972",
            "telephone_number": "586-726-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POCHMARA",
        "first_name": "KENDYL",
        "middle_name": "NOEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-27",
        "last_updated": "2017-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDYL",
            "last_name": "DIEDERICH",
            "middle_name": "NOEL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.