Individual provider Active NPI

Michelle Levy, FNP-BC

  • Family Nurse Practitioner
  • Dearborn, MI
National Provider Identifier
1407524945
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704306425 Issued in MI
Practice address
22361 W Village Dr Ste 102
Dearborn, MI 48124-2227
Phone
(313) 563-2288
NPI assigned
Aug 31, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704306425 MI Primary

Addresses

Primary practice location

22361 W Village Dr Ste 102
Dearborn, MI 48124-2227

Mailing address

22361 W Village Dr Ste 102
Dearborn, MI 48124-2227

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
I20211026000626 MI Practitioner - Nurse Practitioner 2365830221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tenny Internal Medicine PLLCGroup PAC ID 5991127896, 6 clinicians

Practice addresses (Care Compare)

22361 W Village Dr
Suite 102
Dearborn, MI 48124-2227
Phone (313) 563-2288

Hospital & facility affiliations

  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Beaumont Hospital - Taylor Hospital, Taylor, MI, CCN 230270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tenny Internal Medicine PLLC CurrentSince Oct 4, 2021 Accepting new patients
James Bazzi MD PC PastSince Oct 4, 2021 Accepting new patients

Locations

22361 W Village Dr
Dearborn, MI 48124
Phone (313) 350-5859

22361 W Village Dr
Ste 102
Dearborn, MI 48124
Phone (313) 563-2288

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20892/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michelle.levy.1@20892.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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1407524945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22361 W VILLAGE DR STE 102",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22361 W VILLAGE DR STE 102",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242227",
            "telephone_number": "313-563-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVY",
        "first_name": "MICHELLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-31",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704306425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.