Individual provider Active NPI

Gina Carmen Valitutti, PA-C

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1437367067
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004333 Issued in MI
Practice address
4100 John R St
Karmanos Cancer Ctr Midlevels
Detroit, MI 48201-2013
Phone
(800) 527-6266
Fax
(313) 576-8381
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601004333 MI Primary

Addresses

Primary practice location

4100 John R St
Karmanos Cancer Ctr Midlevels
Detroit, MI 48201-2013

Mailing address

1560 E Maple Rd
Suite 400-Credentialing
Troy, MI 48083-1138
Phone (248) 581-5731

Other identifiers 1

IdentifierTypeStateIssuer
1437367067MedicaidMI

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
I20081016000199 MI Practitioner - Physician Assistant 9739247925 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Im Hospitalists PLLCGroup PAC ID 2567621477, 8 clinicians

Practice addresses (Care Compare)

4050 E 12 Mile Rd
Warren, MI 48092-2534
Phone (586) 261-2266

5555 Conner St
Detroit, MI 48213-3448
Phone (313) 344-7730

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601004333MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Physicians Medical Group of Michigan, PC CurrentSince Jan 31, 2014 Accepting new patients
Metro Infectious Disease Consultants, LLC CurrentSince May 1, 2016 Accepting new patients
Metro Infectious Disease Consultants LLC CurrentSince May 1, 2016 Accepting new patients
Telemed Consultants PLLC Past Accepting new patients
Ami Medical Associates PLLC Past Accepting new patients

Locations

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

15474 N Haggerty Rd
Plymouth, MI 48170
Phone (734) 335-6103

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

Organizations & group practices 8

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 2

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1437367067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "248-581-5731",
            "fax_number": "248-581-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "address_2": "KARMANOS CANCER CTR MIDLEVELS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "800-527-6266",
            "fax_number": "313-576-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALITUTTI",
        "first_name": "GINA",
        "middle_name": "CARMEN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437367067",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.