Individual provider Active NPI

Marianne Azneer-Harbut, PA-C

  • Physician Assistant
  • Southfield, MI
National Provider Identifier
1073653259
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601001647 Issued in MI
Practice address
29355 Northwestern Hwy Ste 302B
Southfield, MI 48034-1053
Phone
(248) 228-2990
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7455 GA
Physician Assistant 363A00000X 2354 FL
Physician Assistant 363A00000X 5601001647 MI Primary

Addresses

Primary practice location

29355 Northwestern Hwy Ste 302B
Southfield, MI 48034-1053

Mailing address

29355 Northwestern Hwy Ste 302B
Southfield, MI 48034-1053

Other practice location 1

13314 Hart Avenue
Hunington Woods, MI 48070-0922
Phone (727) 641-4266

Other names 1

  • Marianne Azneer Other 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
I20170719000962 MI Practitioner - Physician Assistant 3072661081 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Singer DermatologyGroup PAC ID 7719256973, 6 clinicians

Practice addresses (Care Compare)

29355 Northwestern Hwy
Suite 302
Southfield, MI 48034-1053

29355 Northwestern Hwy
Suite 302
Southfield, MI 48034-1065
Phone (248) 228-2990

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Merit-based Incentive Payment System (MIPS)

Final score
92.5 of 100Reported as group
Quality
85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2354FLMDPhysician Assistant
7455GAMDPhysician Assistant
5601001647MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Dermatology of Southfield PLLC CurrentSince Aug 17, 2025 Accepting new patients
Audrey Bruell, M.D. P.C. Current Accepting new patients

Locations

37605 Pembroke Ave
Livonia, MI 48152
Phone (734) 591-7931

29355 Northwestern Hwy
Ste 302B
Southfield, MI 48034
Phone (248) 228-2477

Networks

  • Freedom Health HMO Network

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1073653259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29355 NORTHWESTERN HWY STE 302B",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29355 NORTHWESTERN HWY STE 302B",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341053",
            "telephone_number": "248-228-2990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13314 Hart Avenue",
            "address_purpose": "LOCATION",
            "city": "Hunington Woods",
            "state": "MI",
            "postal_code": "480700922",
            "country_code": "US",
            "telephone_number": "727-641-4266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZNEER-HARBUT",
        "first_name": "MARIANNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7455",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "2354",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIANNE",
            "last_name": "AZNEER",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.