Individual provider Active NPI

Katherine Elizabeth Mysliwiec, PA-C

  • Medical Physician Assistant
  • Monroe, MI
National Provider Identifier
1396462198
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601011332 Issued in MI
Practice address
1030 N Monroe St
Monroe, MI 48162-3113
Phone
(734) 682-3309
Fax
(734) 682-1488
NPI assigned
Oct 21, 2022
Last updated
Nov 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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 5601011332 MI Primary

Addresses

Primary practice location

1030 N Monroe St
Monroe, MI 48162-3113

Mailing address

1030 N Monroe St
Monroe, MI 48162-3113
Phone (734) 682-3309

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
I20221205003073 MI Practitioner - Physician Assistant 7416326921 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601011332MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation CurrentSince Jan 1, 2023 Accepting new patients
Iha Health Service Corporation CurrentSince Jan 1, 2023 Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5325 Elliott Dr
Ste 104
Ypsilanti, MI 48197
Phone (734) 434-4200

Organizations & group practices 3

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": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1396462198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 N MONROE ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623113",
            "telephone_number": "734-682-3309",
            "fax_number": "734-682-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 N MONROE ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623113",
            "telephone_number": "734-682-3309",
            "fax_number": "734-682-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYSLIWIEC",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601011332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.