Individual provider Active NPI

Aradhana Thyagaraj, PA

  • Physician Assistant
  • Brownstown TWP, MI
National Provider Identifier
1114010238
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004923 Issued in MI
Practice address
17000 King Rd
Brownstown TWP, MI 48183-1115
Phone
(734) 362-9032
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5601004923 MI Primary

Addresses

Primary practice location

17000 King Rd
Brownstown TWP, MI 48183-1115

Mailing address

9911 Garden St
Livonia, MI 48150-3110
Phone (734) 427-3769

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
I20070122000220 MI Practitioner - Physician Assistant 0547261315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

14555 Levan Rd
Livonia, MI 48154-5083
Phone (734) 655-1590

24555 Haig St
Taylor, MI 48180-3322
Phone (313) 375-2000

24565 Haig St
Taylor, MI 48180-3322
Phone (313) 291-7800

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

6525 2ND Ave
Detroit, MI 48202-3006
Phone (313) 972-4140

6777 W Maple Rd
Henry Ford West Bloomfield Med Ctr
West Bloomfield, MI 48322-3013
Phone (248) 661-4100

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601004923MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Jul 1, 2019 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Jul 1, 2019 Accepting new patients
DMC Orthopedic Billing Associates LLC Past Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

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

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2799 W Grand Blvd
#363
Detroit, MI 48202
Phone (313) 916-2020

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

Interoperability endpoints

  • Direct secure messaging: athyagar@direct.dmc.org
  • Direct secure messaging: athyagaraj604021@direct.hfhs.org

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 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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114010238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9911 GARDEN ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503110",
            "telephone_number": "734-427-3769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 KING RD",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831115",
            "telephone_number": "734-362-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THYAGARAJ",
        "first_name": "ARADHANA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownstown TWP, MI

Sources for this page

Verify at the official NPI Registry.