Individual provider Active NPI

Paige Marie Moeggenborg, NP

  • Nurse Practitioner
  • Farmington Hills, MI
National Provider Identifier
1073408803
Registry record updated Jul 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704390044 Issued in MI
Practice address
30055 Northwestern Hwy Ste 220
Farmington Hills, MI 48334-3275
Phone
(248) 865-9898
NPI assigned
Jun 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704390044 MI
Adult Health Nurse Practitioner 363LA2200X 4704390044 MI
Nurse Practitioner 363L00000X 4704390044 MI Primary

Addresses

Primary practice location

30055 Northwestern Hwy Ste 220
Farmington Hills, MI 48334-3275

Mailing address

30055 Northwestern Hwy Ste 220
Farmington Hills, MI 48334-3275
Phone (248) 865-9898

Other names 1

  • Paige Marie Berman 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
I20250707002005 MI Practitioner - Nurse Practitioner 7517471279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

47601 Grand River Ave
Suite C200
Novi, MI 48374-1203
Phone (248) 380-6624

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704390044MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Providence Hospital CurrentSince Jun 26, 2025 Accepting new patients
Henry Ford Health Providence Hospital Nurse Practitioner Current Accepting new patients
Henry Ford Health Providence Hospital CurrentSince Jun 26, 2025 Accepting new patients
Henry Ford Health Providence Hospital PastSince Jun 1, 2025 Accepting new patients

Locations

30055 Northwestern Hwy
Ste 220
Farmington Hills, MI 48334
Phone (248) 380-6624

47601 Grand River Ave
Ste C200
Novi, MI 48374
Phone (248) 380-6624

22250 Providence Dr
Ste 705
Southfield, MI 48075
Phone (248) 465-5955

Interoperability endpoints

  • Direct secure messaging: paige.berman.1@8209.direct.athenahealth.com

Organizations & group practices 4

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 3

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": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783814400000",
    "number": "1073408803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30055 NORTHWESTERN HWY STE 220",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343275",
            "telephone_number": "248-865-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30055 NORTHWESTERN HWY STE 220",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343275",
            "telephone_number": "248-865-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEGGENBORG",
        "first_name": "PAIGE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-11",
        "last_updated": "2026-07-12",
        "certification_date": "2026-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704390044",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704390044",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704390044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAIGE",
            "last_name": "BERMAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.