Individual provider Active NPI

Michael Darrell Stewart Jr., PA-C

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1154604205
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008437 Issued in MI
Practice address
12800 E Warren Ave
Detroit, MI 48215-2061
Phone
(313) 308-1400
NPI assigned
Sep 26, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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 5601008437 MI Primary

Addresses

Primary practice location

12800 E Warren Ave
Detroit, MI 48215-2061

Mailing address

12800 E Warren Ave
Detroit, MI 48215-2061
Phone (313) 308-1400

Other practice location 1

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcerecords.cnsmi@direct.mihn.net Direct CNS Healthcare

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
I20190130002072 MI Practitioner - Physician Assistant 3971754813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CNS HealthcareGroup PAC ID 8729980198, 24 clinicians
All Well-Being ServicesGroup PAC ID 9133010176, 11 clinicians

Practice addresses (Care Compare)

12800 E Warren Ave
Detroit, MI 48215-2061
Phone (313) 308-1400

1413 Field St
Detroit, MI 48214-2321
Phone (313) 347-2070

1423 Field St
Detroit, MI 48214-2321
Phone (313) 924-7860

24230 Karim Blvd
Suite 100
Novi, MI 48375-2960
Phone (248) 745-4900

30555 Michigan Ave
Westland, MI 48186-5310
Phone (734) 595-3640

Merit-based Incentive Payment System (MIPS)

Final score
87.5 of 100Reported as group
Quality
73.88
Promoting interoperability
80
Improvement activities
40
Cost
78.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601008437MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adult Well Being Services CurrentSince Jun 13, 2023 Accepting new patients

Locations

1413 Field St
Detroit, MI 48214
Phone (313) 347-2070

1423 Field St
Detroit, MI 48214
Phone (313) 347-2070

15222 E Jefferson Ave
Grosse Pointe Park, MI 48230
Phone (313) 265-0441

30555 Michigan Ave
Westland, MI 48186
Phone (734) 595-3640

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1154604205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152061",
            "telephone_number": "313-308-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152061",
            "telephone_number": "313-308-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16001 W 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480754818",
            "country_code": "US",
            "telephone_number": "248-849-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MICHAEL",
        "middle_name": "DARRELL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-26",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.cnsmi@direct.mihn.net",
            "affiliation": "Y",
            "affiliationName": "CNS Healthcare",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "24230 Karim Blvd",
            "address_2": "Suite 100",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483752960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.