Individual provider Active NPI

Marissa Simonne Ghant, MD

  • Student in an Organized Health Care Education/Training Program
  • Ypsilanti, MI
National Provider Identifier
1063918613
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
200 Arnet St Ste 200
Ypsilanti, MI 48198-5753
Phone
(734) 539-5000
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Family Medicine Physician 207Q00000X 4301517872 MI

Addresses

Primary practice location

200 Arnet St Ste 200
Ypsilanti, MI 48198-5753

Mailing address

200 Arnet St Ste 200
Ypsilanti, MI 48198-5753
Phone (734) 539-5000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240619000976 MI Order and Referring Only - Family PracticePractitioner - Family Practice 6800339839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301517872MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan PastSince Jun 16, 2024 Accepting new patients

Organizations & group practices 1

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1063918613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 ARNET ST STE 200",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985753",
            "telephone_number": "734-539-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ARNET ST STE 200",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985753",
            "telephone_number": "734-539-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANT",
        "first_name": "MARISSA",
        "middle_name": "SIMONNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301517872",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.