Individual provider Active NPI

Cinderella Ann Miller Wilkins, PA

  • Medical Physician Assistant
  • Ypsilanti, MI
National Provider Identifier
1346221298
Registry record updated Nov 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601004210 Issued in MI
Practice address
1649 S Huron St
Ypsilanti, MI 48197-9701
Phone
(734) 480-0990
NPI assigned
Nov 8, 2005
Last updated
Nov 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601004210 MI Primary

Addresses

Primary practice location

1649 S Huron St
Ypsilanti, MI 48197-9701

Mailing address

13030 Tireman St
Detroit, MI 48228-2712
Phone (313) 418-6666

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
I20040527000994 MI Practitioner - Physician Assistant 4183605843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Huron Urgent Care Center PLCGroup PAC ID 6901086859, 5 clinicians

Practice addresses (Care Compare)

1649 S Huron St
Ypsilanti, MI 48197-9701
Phone (734) 480-0990

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Home Care Physician PC Medical Past Accepting new patients
Socialaspect Consulting Agency Inc Past Accepting new patients
Heritage Medical Group Medical Past Accepting new patients

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511481600000",
    "number": "1346221298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13030 TIREMAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482282712",
            "telephone_number": "313-418-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 S HURON ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481979701",
            "telephone_number": "734-480-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER WILKINS",
        "first_name": "CINDERELLA",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2017-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.