PACE OF SOUTHWEST MICHIGAN INC (NPI# 1568709392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568709392 |
| Entity Type | Organization |
| Organization Name | PACE OF SOUTHWEST MICHIGAN INC |
| Practice Address |
2900 Lakeview Ave Saint Joseph MI 49085-2379 |
| Practice Telephone | 2694084322 |
| Practice Fax Number | 2694084340 |
| Mailing Telephone | 2694084322 |
| Mailing Fax Number | 2694084340 |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-05-14 |
| Authorized Official Name | THERESE SAGGAU (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2694084322 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICAID BILLING AGENT ID | 2332863 | 01 |
| MI | 2331543 | 05 |
| Street Address |
2900 LAKEVIEW AVE |
| City | SAINT JOSEPH |
| State | MI |
| Zip Code | 49085-2379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366524985 | Region Iv Area Agency On Aging, Inc | Case Management | 2900 Lakeview Ave, Saint Joseph, MI 49085-2379 | 2006-10-20 |
| 1790204501 | Kimberly Renee Budner | Physician Assistant | 2900 Lakeview Ave, Saint Joseph, MI 49085-2379 | 2017-09-12 |
| 1962819763 | Sherry Simpson | Nurse Practitioner | 2900 Lakeview Ave, Saint Joseph, MI 49085-2379 | 2014-07-14 |
| 1003050188 | Region Iv Area Agency On Aging, Inc. | Case Management | 2900 Lakeview Ave, Saint Joseph, MI 49085-2379 | 2009-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758949 | Ahmed Elshareif | Student in an Organized Health Care Education/Training Program | Lakeland Health, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2020-04-03 |
| 1033747225 | Ezra Fox | Student in an Organized Health Care Education/Training Program | Lakeland Health- Gme, 1234 Napier Avenue, St. Joseph, MI 49085 | 2020-04-01 |
| 1679033930 | Asad Butt | Student in an Organized Health Care Education/Training Program | Lakeland Health-gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2019-03-22 |
| 1184194714 | Benjamin Phillip Knuth | Physical Therapist | 3950 Hollywood Road, Suite 140, Saint Joseph, MI 49085 | 2018-11-27 |
| 1336624279 | Brandi Chatot | Counselor | 1101 Broad Street #8, Saint Joseph, MI 49085 | 2018-09-26 |
| 1396239562 | Lakeland Medical Practices | Family Medicine | 2500 Niles Ave., Suite 1, St. Joseph, MI 49085 | 2018-06-20 |
| 1760976518 | Premier Health Associates, Inc. | Home Health | 1111 Main Sr, St Joseph, MI 49085 | 2018-06-15 |
| 1053817783 | Chantell Strong | Student in an Organized Health Care Education/Training Program | Lakeland Health - Gme, 1234 Napier Avenue, Saint Joseph, MI 49085 | 2018-04-02 |
| 1386144053 | Anjana Gupta, Dds, Pllc | Dentist | 2800 Niles Road, Saint Joseph, MI 49085 | 2018-02-19 |
| 1356858997 | Hope Reborn Counseling, Pllc | Counselor | 2816 Willa Dr, Saint Joseph, MI 49085 | 2018-01-04 |
| Find all providers in zip 49085 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992339311 | Kelly R Niezurawski | PACE Provider Organization | 6500 N Hawkins Hwy, Manitou Beach, MI 49253-9736 | 2020-02-25 |
| 1881253540 | Sears Transportaion, LLC | PACE Provider Organization | 17800 Northland Park Ct Ste 104b2, Southfield, MI 48075-4304 | 2019-06-06 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1528549300 | Sonja Hunter | PACE Provider Organization | 14459 Greenview Rd, Detroit, MI 48223-2913 | 2018-08-28 |
| 1639687213 | Eastern Grouphome | PACE Provider Organization | 5770 Eastern Ave Se, Grand Rapids, MI 49508-6281 | 2018-01-17 |
| 1578845095 | Comforter Care Agency | PACE Provider Organization | 4830 Malpaso, Lansing, MI 48917-1554 | 2011-09-10 |
| 1427282136 | Jcb Adult Day Services | PACE Provider Organization | 21500 Greenfield Rd, Suite 201, Oak Park, MI 48237-3009 | 2009-05-08 |
| 1598964926 | Finner-williams & Associates | PACE Provider Organization | 17620 W Mcnichols Rd, Detroit, MI 48235-3327 | 2007-07-16 |
| 1043422660 | Progressive Lifestyles, Inc. | PACE Provider Organization | 2669 Potter Rd, Wixom, MI 48393-1832 | 2007-05-04 |
| 1639244734 | Clean House, Inc. | PACE Provider Organization | 24750 Swanson Rd, Southfield, MI 48034-5320 | 2006-11-22 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 49085 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.