Active NPI
Sarah Lynn Vandaele, PA-C
- Physician Assistant
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (800) 436-7936
- NPI assigned
- Dec 18, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NY | ||
| Physician Assistant | 363A00000X | MI | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (800) 436-7936
Other practice location 1
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-5000
Other practice location 2
44199 Dequindre Rd Ste 315
Troy, MI 48085-1128
Phone (248) 964-3600
Other practice location 3
130 E 77th St
New York, NY 10075-1851
Phone (212) 434-4135
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5601008594 | Other | MI | MICHIGAN STATE LICENSE |
Other names 1
- Sarah Lynn Sisson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018314 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Pathology | Current | Accepting new patients | |
| Henry Ford Health System | Physician Assistant | Current | Accepting new patients |
| Henry Ford Health System | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Physician Assistant | Current | Accepting new patients |
| Henry Ford Macomb Hospital Corporation | Current | Accepting new patients | |
| Henry Ford Macomb Hospital Corporation | Current | Accepting new patients | |
| North Shore - Lij Medical PC | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Henry Ford Maplegrove Center | Past | Accepting new patients |
Locations
15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300
15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800
1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255
44199 Dequindre Rd
Ste 315
Troy, MI 48085
Phone (248) 964-1170
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
130 E 77th St
New York, NY 10075
Phone (212) 434-2606
622 W 168th St
Ph 1137
New York, NY 10032
Phone (212) 305-2575
300 Community Dr
Plandome, NY 11030
972 Brush Hollow Rd
Westbury, NY 11590
Interoperability endpoints
- svandaele602977@direct.hfhs.org
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 10
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.
-
- Physician Assistant
- Detroit, MI
- NPI 1811073901
-
- Family Medicine Physician
- Clinton TWP, MI
- NPI 1134265986
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
-
- General Acute Care Hospital
- Clinton TWP, MI
- NPI 1023114634
-
- Anatomic Pathology & Clinical Pathology Physician
- Detroit, MI
- NPI 1851410005
-
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1790043479
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
Physician Assistant
-
- Children's Substance Abuse Rehabilitation Facility
- West Bloomfield, MI
- NPI 1295767630
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648512000000",
"number": "1467850768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "800-436-7936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "800-436-7936"
}
],
"practiceLocations": [
{
"address_1": "44201 Dequindre Rd",
"address_purpose": "LOCATION",
"city": "Troy",
"state": "MI",
"postal_code": "480851117",
"country_code": "US",
"telephone_number": "248-964-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "44199 Dequindre Rd Ste 315",
"address_purpose": "LOCATION",
"city": "Troy",
"state": "MI",
"postal_code": "480851128",
"country_code": "US",
"telephone_number": "248-964-3600",
"fax_number": "248-964-1188",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "130 E 77th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100751851",
"country_code": "US",
"telephone_number": "212-434-4135",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANDAELE",
"first_name": "SARAH",
"middle_name": "LYNN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-18",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN STATE LICENSE",
"identifier": "5601008594",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SARAH",
"last_name": "SISSON",
"middle_name": "LYNN",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.