Active NPI
Brandie Marie Manni, PA-C
- Physician Assistant
- Allen Park, MI
National Provider Identifier
1346950623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601011498
- Practice address
- 7804 Allen Rd
Allen Park, MI 48101-1702 - Phone
- (313) 562-1985
- NPI assigned
- Nov 28, 2022
- Last updated
- Nov 28, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601011498 | MI | Primary |
Addresses
Primary practice location
7804 Allen Rd
Allen Park, MI 48101-1702
Mailing address
13108 Woodridge Cir
Plymouth, MI 48170-3891
Phone (810) 844-6056
Other names 1
- Brandie Marie Windel
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601011498 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Care Well Medical Center PLLC | Past | Accepting new patients |
Interoperability endpoints
- brandie.manni.1@23214.direct.athenahealth.com
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.
-
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- Dearborn Heights, MI
- NPI 1780292623
-
- Family Medicine Physician
- Dearborn Heights, MI
- NPI 1851107429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669593600000",
"number": "1346950623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13108 WOODRIDGE CIR",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481703891",
"telephone_number": "810-844-6056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7804 ALLEN RD",
"city": "ALLEN PARK",
"state": "MI",
"postal_code": "481011702",
"telephone_number": "313-562-1985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNI",
"first_name": "BRANDIE",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-28",
"last_updated": "2022-11-28",
"certification_date": "2022-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601011498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BRANDIE",
"last_name": "WINDEL",
"middle_name": "MARIE",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Allen Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.