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GRACE PEDIATRICS PC
NPI 1003482019
Clinic/Center - Primary Care in Pontiac, MI

Active since June 01, 2021CLIA 23D2275082 · Waiver
44200 WOODWARD AVE STE 103, PONTIAC, MI 48341(248) 253-9600(248) 253-0980 Get Directions Write a Review

NPPES record last updated: June 1, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Grace Pediatrics Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACE PEDIATRICS PC (NPI 1003482019) is a healthcare organization registered as a primary care in Pontiac, Michigan and active in the NPI registry since June 2021. The organization holds a CLIA Waiver certificate valid through January 16, 2027 and lists Roy Pullukat, Owner, as its authorized official.

NPPES Registry Identity

NPI1003482019
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameGRACE PEDIATRICS PC
Location Address44200 WOODWARD AVE STE 103Pontiac, MI 48341-5046
Mailing Address44200 Woodward Ave Ste 103Pontiac, MI 48341-5046 · (248) 253-9600 · Fax (248) 253-0980
Phone(248) 253-9600
Fax(248) 253-0980
Organization SubpartNo
Authorized OfficialRoy PullukatOwner · (248) 884-3879
Enumeration DateJune 1, 2021
NPPES CertifiedJune 1, 2021
✔ NPI 1003482019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
44200 WOODWARD AVE STE 103, Pontiac, MI 48341
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2275082

Grace Pediatrics PC · Pontiac, MI
Active · expires Jan 16, 2027
CLIA Number23D2275082
Laboratory TypePhysician Office
Certificate Effective DateJanuary 17, 2025
Certificate Expiration DateJanuary 16, 2027
Laboratory DirectorRoy J. Pullukat
Laboratory Phone(248) 253-9600
Laboratory LocationGrace Pediatrics PC44200 Woodward Avenue Suite 103, Pontiac, MI 48341
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNAMMA PULLUKAT
Pediatrics
44200 WOODWARD AVE STE 103
PONTIAC, MI 48341
Oakland County (248) 253-9600
ANNAMMA PULLUKAT
Pediatrics (Adolescent Medicine)
44200 WOODWARD AVE STE 103
PONTIAC, MI 48341
Oakland County (248) 253-9600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grace Pediatrics PC's NPI number?

The NPI number for Grace Pediatrics PC is 1003482019. It was assigned to this organization in the NPPES registry on June 1, 2021.

Where is Grace Pediatrics PC located?

Grace Pediatrics PC is located at 44200 Woodward Ave Ste 103, Pontiac, MI 48341. The listed phone number is (248) 253-9600.

What is Grace Pediatrics PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Grace Pediatrics PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2275082) is associated with this NPI, valid through January 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Grace Pediatrics PC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Grace Pediatrics PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Grace Pediatrics PC was last updated on June 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.