Individual provider Active NPI

Diana Wilsher, D.O.

  • Family Medicine Physician
  • Trenton, MI
National Provider Identifier
1265441737
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013495 Issued in MI
Practice address
1640 Fort St
Suite D
Trenton, MI 48183-2040
Phone
(734) 671-6741
Fax
(734) 671-1038
NPI assigned
Aug 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101013495 MI Primary

Addresses

Primary practice location

1640 Fort St
Suite D
Trenton, MI 48183-2040

Mailing address

36659 Canyon Dr
Westland, MI 48186-3400

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101228000353 MI Practitioner - Family Practice 9436347903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A and G Aesthetics PLLCGroup PAC ID 8022101740, 8 clinicians

Practice addresses (Care Compare)

3200 Greenfield Rd
Dearborn, MI 48120-1802
Phone (866) 607-2308

441 S Livernois Rd
Suite 260
Rochester Hills, MI 48307-2593
Phone (866) 607-2308

9392 N Lilley Rd
Plymouth, MI 48170-4610
Phone (866) 607-2308

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Vein Restoration Mi PLLC CurrentSince Jun 1, 2021 Accepting new patients
Center for Vein Restoration Mi PLLC CurrentSince Jun 1, 2021 Accepting new patients
MVC PA PLLC Past Accepting new patients

Locations

3810 W Centre Ave
Ste A
Portage, MI 49024

15255 Northline Rd
Southgate, MI 48195
Phone (734) 285-3090

Interoperability endpoints

  • Direct secure messaging: diana.wilsherdo.p3@direct.cvr.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265441737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36659 CANYON DR",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481863400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 FORT ST",
            "address_2": "SUITE D",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832040",
            "telephone_number": "734-671-6741",
            "fax_number": "734-671-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSHER",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

Verify at the official NPI Registry.