Individual provider Active NPI

Tricia Humerickhouse, PA

  • Physician Assistant
  • Bay City, MI
National Provider Identifier
1265832687
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007083 Issued in MI
Practice address
2110 16TH St
Bay City, MI 48708-7609
Phone
(989) 846-3564
Fax
(989) 846-3557
NPI assigned
Sep 4, 2014
Last updated
Mar 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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 5601007083 MI Primary

Addresses

Primary practice location

2110 16TH St
Bay City, MI 48708-7609

Mailing address

3785 Bay Rd
Saginaw, MI 48603-2433
Phone (989) 791-2455

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
I20141031001380 MI Practitioner - Physician Assistant 5698996833 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tazeen Ahmed LLCGroup PAC ID 2769768209, 2 clinicians

Practice addresses (Care Compare)

2110 16TH St
Suite 4
Bay City, MI 48708-7609
Phone (989) 891-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.12 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
73.74

National Provider Directory

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

Organizations & group practices 2

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 5

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": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1265832687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3785 BAY RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032433",
            "telephone_number": "989-791-2455",
            "fax_number": "989-791-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 16TH ST",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487087609",
            "telephone_number": "989-846-3564",
            "fax_number": "989-846-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMERICKHOUSE",
        "first_name": "TRICIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

Verify at the official NPI Registry.