Individual provider Active NPI

Luis Alexander Sanchez-Erebia, PA-C

  • Physician Assistant
  • Jackson, MI
National Provider Identifier
1043872740
Registry record updated May 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11424 Issued in NC
Practice address
309 Page Ave
Jackson, MI 49201-2419
Phone
(517) 205-1234
NPI assigned
Jul 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2024

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 0010-11424 NC Primary

Addresses

Primary practice location

309 Page Ave
Jackson, MI 49201-2419

Mailing address

309 Page Ave
Jackson, MI 49201-2419
Phone (517) 205-1234

Other practice location 1

12028 Wade Park Ave
Cleveland, OH 44106-4437
Phone (248) 930-5448

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
I20231013002152 MI Practitioner - Physician Assistant 6507269867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

205 N E Ave
Jackson, MI 49201-1753

7845 Spring Arbor Rd
Spring Arbor, MI 49283-9785
Phone (517) 205-2580

813 W Michigan Ave
Henry Ford Allegiance Osteoporosis Center
Jackson, MI 49202-4158
Phone (517) 205-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wa Foote Memorial Hospital, Inc CurrentSince Oct 1, 2023 Accepting new patients
W.a. Foote Memorial Hospital, Inc Physician Assistant CurrentSince Oct 1, 2023 Accepting new patients
Wa Foote Memorial Hospital, Inc Physician Assistant Past Accepting new patients

Locations

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

309 Page Ave
Jackson, MI 49201
Phone (517) 205-1234

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

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.

Hospital & facility affiliations 1

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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716595200000",
    "number": "1043872740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 PAGE AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012419",
            "telephone_number": "517-205-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 PAGE AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012419",
            "telephone_number": "517-205-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12028 Wade Park Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441064437",
            "country_code": "US",
            "telephone_number": "248-930-5448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANCHEZ-EREBIA",
        "first_name": "LUIS",
        "middle_name": "ALEXANDER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2024-05-25",
        "certification_date": "2024-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.