Individual provider Active NPI

Demiana E Attalla, PA

  • Physician Assistant
  • Sterling Heights, MI
National Provider Identifier
1194580910
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012331 Issued in MI
Practice address
13409 E 14 Mile Rd
Sterling Heights, MI 48312-6304
Phone
(586) 977-3900
NPI assigned
Feb 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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 5601012331 MI Primary

Addresses

Primary practice location

13409 E 14 Mile Rd
Sterling Heights, MI 48312-6304

Mailing address

13409 E 14 Mile Rd
Sterling Heights, MI 48312-6304
Phone (586) 977-3900

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
I20241030002644 MI Practitioner - Physician Assistant 1153854013 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sterling Medical Center PLLCGroup PAC ID 6002136868, 3 clinicians

Practice addresses (Care Compare)

13409 E 14 Mile Rd
Sterling Heights, MI 48312-6304
Phone (586) 977-3900

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601012331MIMDPhysician Assistant

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.

Hospital & facility affiliations 3

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": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1194580910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13409 E 14 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483126304",
            "telephone_number": "586-977-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13409 E 14 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483126304",
            "telephone_number": "586-977-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTALLA",
        "first_name": "DEMIANA",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.