Individual provider Active NPI

Mona Sater, PA.C.

  • Surgical Physician Assistant
  • Clarkston, MI
National Provider Identifier
1053391847
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601003312 Issued in MI
Practice address
7650 Dixie Hwy
Suite 140
Clarkston, MI 48346-2078
Phone
(248) 620-9310
Fax
(248) 620-9311
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5601003312 MI Primary

Addresses

Primary practice location

7650 Dixie Hwy
Suite 140
Clarkston, MI 48346-2078

Mailing address

4409 Gaylord Dr
Troy, MI 48098-4458
Phone (248) 225-6887

Other identifiers 1

IdentifierTypeStateIssuer
970030994OtherMIRAILROAD MEDICARE

Other names 1

  • Mona Kobeissi Former name

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
I20081219000367 MI Practitioner - Physician Assistant 9234209743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of Oakland County, P.C. Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Prime Homecare Agency LLCBloomfield Hills, MI, CCN 239027 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Director
Aug 25, 2009
Feb 19, 2008

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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 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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1053391847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 GAYLORD DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480984458",
            "telephone_number": "248-225-6887",
            "fax_number": "248-952-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7650 DIXIE HWY",
            "address_2": "SUITE 140",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462078",
            "telephone_number": "248-620-9310",
            "fax_number": "248-620-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATER",
        "first_name": "MONA",
        "credential": "PA.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601003312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970030994",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONA",
            "last_name": "KOBEISSI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.