Individual provider Active NPI

Samantha Thomas, PA-C

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1104578582
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010902 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-2600
NPI assigned
Jan 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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 5601010902 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

PO Box 670884
Detroit, MI 48267-0884
Phone (313) 874-4806

Other practice location 1

20769 E 13 Mile Rd
Roseville, MI 48066-4503
Phone (586) 872-2288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220215002310 MI Practitioner - Physician Assistant 8527451582 Reassigns benefits to 11 organizations
I20240621000359 FL Practitioner - Physician Assistant 8527451582

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Get Well Urgent Care Shelby PLCGroup PAC ID 0749646412, 16 clinicians
Get Well Urgent Care Macomb PLCGroup PAC ID 6204232176, 19 clinicians
Roseville Urgent Care PCGroup PAC ID 8921281361, 21 clinicians
Oak Park Urgent Care PLLCGroup PAC ID 6305169988, 23 clinicians
Get Well Urgent Care Sterling Heights PLCGroup PAC ID 8820405400, 19 clinicians

Practice addresses (Care Compare)

13467 23 Mile Rd
Shelby Township, MI 48315-2717
Phone (586) 884-7400

15945 19 Mile Rd
Suite 102
Clinton TWP, MI 48038-1147
Phone (586) 431-9100

20769 E 13 Mile Rd
Roseville, MI 48066-4503
Phone (586) 872-2288

24661 Coolidge Hwy
Oak Park, MI 48237-1449
Phone (248) 398-4000

2567 Metropolitan Pkwy
Sterling Heights, MI 48310-7146
Phone (586) 754-0000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601010902MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Urgent Care PLLC Past Accepting new patients
Eastpointe Urgent Care Walk in Clinic P.C. PastSince Jun 14, 2025 Accepting new patients
Garg and Associates Inc Past Accepting new patients

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1104578582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670884",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670884",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20769 E 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MI",
            "postal_code": "480664503",
            "country_code": "US",
            "telephone_number": "586-872-2288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SAMANTHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.