Individual provider Active NPI

Cassandra Alyssa Tavtigian

  • Advanced Practice Midwife
  • Dearborn, MI
National Provider Identifier
1164090106
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
4704314322 Issued in MI
Practice address
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone
(313) 593-7000
NPI assigned
Jun 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 4704314322 MI Primary

Addresses

Primary practice location

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

5557 Cass Ave
Detroit, MI 48202-3615
Phone (313) 577-4082

Other names 1

  • Cassandra Alyssa Casas-Torrez Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ctavtigian1258436@epic00.shdirect.org
Other URL WSU

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251119000203 MI Practitioner - Certified Nurse Midwife (CNM) 4587155478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Wayne State University School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

26901 Beaumont Blvd
Southfield, MI 48033-3849

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
4704314322MIMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group Hospital -Based Services CurrentSince Nov 17, 2025 Accepting new patients

Locations

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Organizations & group practices 1

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": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1164090106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5557 Cass Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482023615",
            "country_code": "US",
            "telephone_number": "313-577-4082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAVTIGIAN",
        "first_name": "CASSANDRA",
        "middle_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704314322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctavtigian1258436@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "18101 Oakwood Blvd",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481244089",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "WSU",
            "affiliation": "N",
            "address_1": "5557 Cass Ave",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482023615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "CASAS-TORREZ",
            "middle_name": "ALYSSA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.