Individual provider Active NPI

Taylor Catherine Taraski, PA-C

  • Physician Assistant
  • Royal Oak, MI
National Provider Identifier
1205355773
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008395 Issued in MI
Practice address
3577 W 13 Mile Rd Ste 103
Royal Oak, MI 48073-6710
Phone
(248) 288-4500
Fax
(248) 288-0450
NPI assigned
Sep 15, 2017
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 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 5601008395 MI Primary

Addresses

Primary practice location

3577 W 13 Mile Rd Ste 103
Royal Oak, MI 48073-6710

Mailing address

130 Town Center Dr Ste 203
Troy, MI 48084-1744
Phone (248) 585-8216

Other practice location 1

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-4866

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
I20171004001492 MI Practitioner - Physician Assistant 0547535338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals, P.C. CurrentSince Mar 1, 2020 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Mar 1, 2020 Accepting new patients
Michigan Healthcare Professionals PC Past Accepting new patients

Locations

6770 Dixie Hwy
Ste 107
Clarkston, MI 48346
Phone (248) 625-7506

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

3577 W 13 Mile Rd
Ste 103
Royal Oak, MI 48073
Phone (248) 288-4500

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

4550 Investment Dr
Ste B120
Troy, MI 48098
Phone (248) 267-6569

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1205355773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TOWN CENTER DR STE 203",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841744",
            "telephone_number": "248-585-8216",
            "fax_number": "248-585-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3577 W 13 MILE RD STE 103",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-288-4500",
            "fax_number": "248-288-0450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-4866",
            "fax_number": "248-964-4848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARASKI",
        "first_name": "TAYLOR",
        "middle_name": "CATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.