Mona Y Wissa, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704319387 Issued in MI

Practice address

8244 Metro Pkwy
Sterling Heights, MI 48312-2778

Phone

(586) 795-4060

Fax

(586) 864-7567

NPI assigned

Jan 8, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lakeview Medical Center PC

  • Internal Medicine Physician
  • Saint Clair Shores, MI
  • NPI 1285950162
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment NPD
• Sabah Internal Medicine PLLC

  • Internal Medicine Physician
  • Roseville, MI
  • NPI 1770029621
  NPD (past)

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

{
    "created_epoch": "1641600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641600000000",
    "number": "1043971369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SCENIC HOLLOW DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483063249",
            "telephone_number": "586-242-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8244 METRO PKWY",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483122778",
            "telephone_number": "586-795-4060",
            "fax_number": "586-864-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSA",
        "first_name": "MONA",
        "middle_name": "Y",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-08",
        "last_updated": "2022-01-08",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704319387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenyal Wilson
• Keti Wilson
• Samikia Wilson
• Janisa Wimberly, RN
• Michelle Winokur
• David Michael Witkowski Jr.
• Bernhardt Hendrick Witzke, C.S.A.
• Katelynn Wizinsky, LLMSW
• Malgorzata Wlodarczyk, DDS
• Michael S Wojcik, DDS,MS

• Gerontology Nurse Practitioner in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.