Individual provider Active NPI

Sara Elizabeth Hayes, PA-C

  • Dermatology Physician
  • Canton, MI
National Provider Identifier
1366811515
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
5601007471 Issued in MI
Practice address
285 N Lilley Rd
Canton, MI 48187-3907
Phone
(734) 495-1506
Fax
(734) 495-1780
NPI assigned
Sep 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 5601007471 MI Primary

Addresses

Primary practice location

285 N Lilley Rd
Canton, MI 48187-3907

Mailing address

43451 Dalcoma Drive
Suite 4
Clinton Township, MI 48038
Phone (586) 286-8720

Other names 1

  • Miss Sara Elizabeth Gallemore Former name

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
I20151030001150 MI Practitioner - Physician Assistant 9335459577 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Specialists of Canton PLLCGroup PAC ID 6507923976, 18 clinicians

Practice addresses (Care Compare)

285 N Lilley Rd
Canton, MI 48187-3907
Phone (734) 495-1506

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601007471MIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Semi Medical Group CurrentSince Oct 1, 2015 Accepting new patients
Henry Ford Semi Medical Group CurrentSince Oct 1, 2015 Accepting new patients
S L Husain Hamzavi MD PC Dermatology CurrentSince Aug 1, 2017 Accepting new patients

Locations

361 N Canton Center Rd
Canton, MI 48187
Phone (734) 495-1506

285 N Lilley Rd
Canton, MI 48187
Phone (734) 495-1506

285 N Lilley Rd
Canton, MI 48187
Phone (734) 495-1506

43151 Dalcoma Dr
Ste 1
Clinton Twp, MI 48038
Phone 5862868720308

43151 Dalcoma Dr
Ste 6
Clinton Twp, MI 48038

3333 Spring Arbor Rd
Jackson, MI 49203
Phone (517) 629-5581

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366811515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43451 DALCOMA DRIVE",
            "address_2": "SUITE 4",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "48038",
            "telephone_number": "586-286-8720",
            "fax_number": "586-649-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 N LILLEY RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873907",
            "telephone_number": "734-495-1506",
            "fax_number": "734-495-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "SARA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5601007471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "GALLEMORE",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.