Individual provider Active NPI

Thomas Charles Catrett III

  • Medical Physician Assistant
  • Grosse Pointe Woods, MI
National Provider Identifier
1194006403
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
1605 Bournemouth Rd
Grosse Pointe Woods, MI 48236-1989
Phone
(313) 492-8666
NPI assigned
Aug 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MI Primary
Physician Assistant 363A00000X 5601006159 MI

Addresses

Primary practice location

1605 Bournemouth Rd
Grosse Pointe Woods, MI 48236-1989

Mailing address

1605 Bournemouth Rd
Grosse Pointe Woods, MI 48236-1989

Other identifiers 1

IdentifierTypeStateIssuer
700H231390OtherMIBCBS GROUP 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
I20120109000946 MI Practitioner - Physician Assistant 5496921694 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601006159MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Macomb Oakland Hospital Physician Assistant CurrentSince Dec 20, 2020 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Jan 2, 2018 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Jan 2, 2018 Accepting new patients

Locations

7733 E Jefferson Ave
Detroit, MI 48214
Phone (313) 499-3000

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

27483 Dequindre Rd
Ste 204
Madison Hts, MI 48071
Phone (248) 967-7326

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: tcatrett1120578@direct.hfhs.org

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": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1194006403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 BOURNEMOUTH RD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 BOURNEMOUTH RD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361989",
            "telephone_number": "313-492-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATRETT",
        "first_name": "THOMAS",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006159",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "700H231390",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.