Individual provider Active NPI

Amanda M Eisenmann, PA

  • Physician Assistant
  • Chelsea, MI
National Provider Identifier
1497135842
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007327 Issued in MI
Practice address
14650 East Old US Highway 12
Suite 306
Chelsea, MI 48118
Phone
(734) 475-5003
NPI assigned
Jun 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2018

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 5601007327 MI Primary

Addresses

Primary practice location

14650 East Old US Highway 12
Suite 306
Chelsea, MI 48118

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 936-4000

Other names 1

  • Amanda Laberdee 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
I20150810001033 MI Practitioner - Physician Assistant 8426362112 Reassigns benefits to 2 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

Practice addresses (Care Compare)

1801 Briarwood Cir
Ann Arbor, MI 48108-3347
Phone (734) 539-5000

775 S Main St
SJM Chelsea Hospital
Chelsea, MI 48118-1383
Phone (734) 936-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Observation Physicians PLLC CurrentSince Jul 6, 2015 Accepting new patients
Regents of the University of Michigan Physician Assistant CurrentSince May 8, 2018 Accepting new patients
Regents of the University of Michigan CurrentSince May 8, 2018 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Fl 2
Ann Arbor, MI 48109
Phone (734) 936-5738

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1801 Briarwood Cir
Ann Arbor, MI 48108
Phone (734) 539-5000

14650 E Old US Highway 12
Ste 201
Chelsea, MI 48118
Phone (734) 433-4504

14650 E Old US Highway 12
Ste 306
Chelsea, MI 48118
Phone (734) 475-4003

14650 E Old US Highway 12
Chelsea, MI 48118
Phone (734) 475-2600

14700 E Old US Highway 12
Chelsea, MI 48118
Phone (734) 475-1321

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

Organizations & group practices 6

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": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525996800000",
    "number": "1497135842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-936-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 EAST OLD US HIGHWAY 12",
            "address_2": "SUITE 306",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "48118",
            "telephone_number": "734-475-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENMANN",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2018-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "LABERDEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chelsea, MI

Sources for this page

Verify at the official NPI Registry.