Individual provider Active NPI

Paul M Villiard, MS, PA-C

  • Surgical Physician Assistant
  • Ypsilanti, MI
National Provider Identifier
1255393575
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601005390 Issued in MI
Practice address
5315 Elliott Dr
Suite 301
Ypsilanti, MI 48197-8634
Phone
(734) 572-4500
Fax
(734) 572-4529
NPI assigned
Apr 3, 2006
Last updated
Jun 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5601005390 MI Primary

Addresses

Primary practice location

5315 Elliott Dr
Suite 301
Ypsilanti, MI 48197-8634

Mailing address

5315 Elliott Dr
Suite 301
Ypsilanti, MI 48197-8634
Phone (734) 572-4500

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
I20081213000042 MI Practitioner - Physician Assistant 4789745464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Mercy HospitalGroup PAC ID 3779489281, 69 clinicians

Practice addresses (Care Compare)

5301 E Huron River Dr
Ann Arbor, MI 48197-1051
Phone (734) 712-3456

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601005390MIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Mercy Hospital Surgical CurrentSince Nov 22, 2016 Accepting new patients
St Joseph Mercy Hospital Current Accepting new patients
St Joseph Mercy Hospital Current Accepting new patients
St Joseph Mercy Hospital CurrentSince Nov 22, 2016 Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients

Locations

34505 W 12 Mile Rd
Ste 200
Farmington Hills, MI 48331
Phone (734) 343-3922

5315 Elliott Dr
Ste 301
Ypsilanti, MI 48197
Phone (734) 572-4500

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

111 N Huron St
Ste 203
Ypsilanti, MI 48197
Phone (734) 480-0033

Interoperability endpoints

  • Direct secure messaging: pvilliard44944@direct.trinity-health.org

Organizations & group practices 6

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1255393575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 ELLIOTT DR",
            "address_2": "SUITE 301",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978634",
            "telephone_number": "734-572-4500",
            "fax_number": "734-572-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 ELLIOTT DR",
            "address_2": "SUITE 301",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978634",
            "telephone_number": "734-572-4500",
            "fax_number": "734-572-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLIARD",
        "first_name": "PAUL",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601005390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.