NPIMap

Individual provider Active NPI

Anita Mary Shamoun, P.A-C

  • Medical Physician Assistant
  • Detroit, MI
National Provider Identifier
1043564941
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601006497 Issued in MI
Practice address
6071 W Outer Dr
Detroit, MI 48235-2624
Phone
(313) 966-3300
NPI assigned
Oct 31, 2012
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0007438 CO
Medical Physician Assistant 363AM0700X 5601006497 MI Primary
Medical Physician Assistant 363AM0700X PA.0007438 CO

Addresses

Primary practice location

6071 W Outer Dr
Detroit, MI 48235-2624

Mailing address

39080 Plumbrook Dr
Farmington Hills, MI 48331-2972
Phone (248) 379-4648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140115000948 MI Practitioner - Physician Assistant 8921236118 Reassigns benefits to 3 organizations
I20230405002199 CO Practitioner - Physician Assistant 8921236118 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Consultants of Colorado PCGroup PAC ID 6204748452, 6 clinicians

Practice addresses (Care Compare)

2000 S Colorado Blvd
Suite 420
Denver, CO 80222-7907
Phone (720) 524-1550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0007438COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Hospitalist Services, PLLC Physician Assistant CurrentSince Apr 24, 2023 Accepting new patients
Inpatient Consultants of Colorado PC CurrentSince Oct 9, 2023 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Nov 1, 2018 Accepting new patients
Henry Ford Health System CurrentSince Nov 1, 2018 Accepting new patients
Inpatient Consultants of Colorado, PC Physician Assistant Past Accepting new patients

Locations

2000 S Colorado Blvd
Ste 420
Denver, CO 80222
Phone (720) 524-1550

501 E Hampden Ave
Englewood, CO 80113
Phone (303) 788-5300

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

Interoperability endpoints

  • Direct secure messaging: ashamoun@direct.dmc.org
  • Direct secure messaging: ashamoun554427@direct.hfhs.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1043564941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39080 PLUMBROOK DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483312972",
            "telephone_number": "248-379-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMOUN",
        "first_name": "ANITA",
        "middle_name": "MARY",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007438",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006497",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0007438",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.