Individual provider Active NPI

Sommer Elyse Shefferly, PA-C

  • Physician Assistant
  • Farmington Hills, MI
National Provider Identifier
1215699434
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010854 Issued in MI
Practice address
23700 Orchard Lake Rd
Farmington Hills, MI 48336-2559
Phone
(248) 482-6222
NPI assigned
Oct 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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 5601010854 MI Primary

Addresses

Primary practice location

23700 Orchard Lake Rd
Farmington Hills, MI 48336-2559

Mailing address

3280 Kenwood St
Ferndale, MI 48220-1133
Phone (248) 703-7980

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
I20260326001732 MI Practitioner - Physician Assistant 1052896222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

23700 Orchard Lake Rd
Suite M
Farmington Hills, MI 48336-2548

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601010854MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Powers Family Medicine PLLC CurrentSince Oct 10, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sommer.shefferly.1@25557.direct.athenahealth.com
  • Direct secure messaging: sshefferly736017@direct.hfhs.org
  • FHIR API: https://api.platform.athenahealth.com/25557/brand/1/csg/1/fhir/r4

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": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1215699434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 KENWOOD ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201133",
            "telephone_number": "248-703-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23700 ORCHARD LAKE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362559",
            "telephone_number": "248-482-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEFFERLY",
        "first_name": "SOMMER",
        "middle_name": "ELYSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.