Individual provider Active NPI

Michelle E Lexmond, P.A.

  • Physician Assistant
  • Carol Stream, IL
National Provider Identifier
1144208067
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003539 Issued in MI
Practice address
4602 Dept
Carol Stream, IL 60122-4602
Phone
(906) 225-3630
Fax
(906) 225-4537
NPI assigned
Jan 3, 2006
Last updated
Sep 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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 5601003539 MI Primary

Addresses

Primary practice location

4602 Dept
Carol Stream, IL 60122-4602

Mailing address

PO Box 220
Marquette, MI 49855-0220
Phone (888) 674-0854

Other identifiers 1

IdentifierTypeStateIssuer
5601003539OtherMIMICHIGAN LICENSE NUMBER

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
I20060206000901 MI Practitioner - Physician Assistant 3173538568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1400 W Washington St
Marquette, MI 49855-3116
Phone (906) 449-1600

1414 W Fair Ave
Marquette, MI 49855-2675

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
Marquette Medical Mindful Wellness Past Accepting new patients
DLP Marquette Physician Practices Inc Physician Assistant Past Accepting new patients

Locations

710 S Lincoln Rd
Ste 700
Escanaba, MI 49829
Phone (906) 786-2172

1400 W Washington St
Ofc
Marquette, MI 49855

1414 W Fair Ave
Ste 344
Marquette, MI 49855
Phone (906) 225-3910

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

420 W Magnetic St
Marquette, MI 49855
Phone (906) 225-3540

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

Interoperability endpoints

  • Direct secure messaging: michelle.lexmond.1@8233.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1144208067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498550220",
            "telephone_number": "888-674-0854",
            "fax_number": "906-225-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 DEPT",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601224602",
            "telephone_number": "906-225-3630",
            "fax_number": "906-225-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEXMOND",
        "first_name": "MICHELLE",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE NUMBER",
            "identifier": "5601003539",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carol Stream, IL

Sources for this page

Verify at the official NPI Registry.