Individual provider Active NPI

Edith Anne Chittenden, PA-C

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1104161686
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
311 Mack Ave Ste 64100
Detroit, MI 48201-2466
Phone
(313) 832-0303
Fax
(313) 745-9222
NPI assigned
Dec 10, 2012
Last updated
Sep 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MD Primary

Addresses

Primary practice location

311 Mack Ave Ste 64100
Detroit, MI 48201-2466

Mailing address

1800 Orleans St
Sheikh Zayed Tower 7107
Baltimore, MD 21287-0010
Phone (410) 614-2210

Other practice location 1

1800 Orleans St
Sheikh Zayed Tower 7107
Baltimore, MD 21287-0010
Phone (410) 614-2210

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
I20191204000936 MI Practitioner - Physician Assistant 4486809266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

3901 Beaubien 1St Floor
Detroit, MI 48201-2119
Phone (313) 745-5227

3901 Beaubien St
Detroit, MI 48201-2119

3990 John R St
Detroit, MI 48201-2018

6071 W Outer Dr
Detroit, MI 48235-2624

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.26 of 100Reported as group
Quality
64.16
Promoting interoperability
100
Improvement activities
40
Cost
73.79

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: edith.chittenden.1@9704.direct.athenahealth.com

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, 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": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1104161686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 ORLEANS ST",
            "address_2": "SHEIKH ZAYED TOWER 7107",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870010",
            "telephone_number": "410-614-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MACK AVE STE 64100",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012466",
            "telephone_number": "313-832-0303",
            "fax_number": "313-745-9222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Orleans St",
            "address_2": "Sheikh Zayed Tower 7107",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870010",
            "country_code": "US",
            "telephone_number": "410-614-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHITTENDEN",
        "first_name": "EDITH",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-10",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.