Mitchell Misiak, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008190 Issued in MI

Practice address

36622 Five Mile Rd
Livonia, MI 48154-1900

Phone

(586) 261-2080

Fax

(586) 261-2080

NPI assigned

May 17, 2017

Last updated

May 17, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: mmisiak1141769@direct.hfhs.org

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.

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  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494979200000",
    "number": "1508393984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27472 SCHOENHERR RD STE 140",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886681",
            "telephone_number": "586-439-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36622 FIVE MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541900",
            "telephone_number": "586-261-2080",
            "fax_number": "586-261-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISIAK",
        "first_name": "MITCHELL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-17",
        "last_updated": "2017-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blegina Miraka, DMD
• Neil Kenneth Miran
• Ayline Miranda
• Ashra Mirza, NP
• Lana Mirza, MD
• Suhasini S Mistry, M.D.
• Michael Salvatore Misuraca, DO
• Alicia Mitchell
• Andrew J Mitchell, M.D.
• Benjamin Patrick Mitchell

• Physician Assistant in Livonia, MI
• Providers in Livonia, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.