Individual provider Active NPI

Susan A. Villemure, P.A.

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1154465441
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004066 Issued in MI
Practice address
2799 W Grand Blvd
K 17
Detroit, MI 48202-2608
Phone
(313) 916-2436
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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 5601004066 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
K 17
Detroit, MI 48202-2608

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450

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
I20060117000807 MI Practitioner - Physician Assistant 1456375526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
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)

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

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
5601004066MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Oct 10, 2005 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Oct 10, 2005 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

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

2799 W Grand Blvd
#5
Detroit, MI 48202
Phone (313) 916-2710

2799 W Grand Blvd
#17
Detroit, MI 48202
Phone (313) 916-2436

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

Interoperability endpoints

  • Direct secure messaging: svillemure15935@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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1154465441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "K 17",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLEMURE",
        "first_name": "SUSAN",
        "middle_name": "A.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.