Sara Atisha

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4001 W McNichols Rd
Detroit, MI 48221-3038

Phone

(313) 993-1245

NPI assigned

Oct 26, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Joel L Young MD PCGroup PAC ID 3971575929, 59 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Joel L. Young, M.D., P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rochester Hills, MI
  • NPI 1396753729
  Medicare reassignment Care Compare group
• University of Detroit Mercy

  • General Practice Physician
  • Detroit, MI
  • NPI 1669187696
  NPD (past)

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1316601206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8550 PINE COVE DR",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483824456",
            "telephone_number": "248-933-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482213038",
            "telephone_number": "313-993-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATISHA",
        "first_name": "SARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shobana Athimulam, MBBS
• Athletic Scholars
• Athletico LTD
• Athomecare4Seniors
• Andrew Atisha, DMD
• Amber Atkins
• Anne Marie Atkins, DDS
• Lalonda R Atkins, RN
• Nikhol Janeen Atkins
• Atlanta VA Medical Center

• Physician Assistant in Detroit, MI
• Providers in Detroit, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.