Individual provider Active NPI

Gretchen E Zajac, PA-C

  • Physician Assistant
  • Ann Arbor, MI
National Provider Identifier
1013386101
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007403 Issued in MI
Practice address
1500 E. Medical Center Dr
2ND Floor Taubman Center Recp B
Ann Arbor, MI 48109-5328
Phone
(734) 936-5780
NPI assigned
Sep 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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 5601007403 MI Primary

Addresses

Primary practice location

1500 E. Medical Center Dr
2ND Floor Taubman Center Recp B
Ann Arbor, MI 48109-5328

Mailing address

3621 South State Street
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

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
I20151022001429 MI Practitioner - Physician Assistant 8022327659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

775 S Main St
Chelsea, MI 48118-1383

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation CurrentSince Oct 1, 2019 Accepting new patients
Iha Health Services Corporation CurrentSince Oct 1, 2019 Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Interoperability endpoints

  • Direct secure messaging: gzajac184534@direct.trinity-health.org

Organizations & group practices 3

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": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444089600000",
    "number": "1013386101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 SOUTH STATE STREET",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E. MEDICAL CENTER DR",
            "address_2": "2ND FLOOR TAUBMAN CENTER RECP B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095328",
            "telephone_number": "734-936-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJAC",
        "first_name": "GRETCHEN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-18",
        "last_updated": "2015-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.