Individual provider Active NPI

Emily Eaton, PA-C

  • Physician Assistant
  • Lansing, MI
National Provider Identifier
1205665643
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012563 Issued in MI
Practice address
1215 E Michigan Ave
Lansing, MI 48912-1811
Phone
(517) 364-1000
NPI assigned
Aug 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 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 5601012563 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave
Lansing, MI 48912-1811

Mailing address

3938 N Rosebud CT SE Apt 9
Kentwood, MI 49512-9469

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
I20240828004120 MI Practitioner - Physician Assistant 6103365622 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians
Vituity - Michigan Hospitalists PCGroup PAC ID 2365860996, 76 clinicians

Practice addresses (Care Compare)

10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850

1215 E Michigan Ave
Lansing, MI 48912-1811
Phone (517) 364-1000

220 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5050

250 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5600

406 E Elm St
Carson City, MI 48811-9693
Phone (989) 584-3131

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary'S Medical Group Physician Assistant CurrentSince Dec 23, 2025 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Dec 23, 2025 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

Organizations & group practices 5

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": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1205665643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3938 N ROSEBUD CT SE APT 9",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495129469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.