NPIMap

Individual provider Active NPI

Abigail Rose Mayone, PA-C

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1508461047
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010321 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-2181
Fax
(313) 916-2478
NPI assigned
Dec 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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 5601010321 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 (313) 916-2181

Other practice location 1

1961 S Telegraph Rd
Bloomfield Hills, MI 48302-0246
Phone (248) 319-6160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201214000701 MI Practitioner - Physician Assistant 6406268655 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

6777 W Maple Rd
Henry Ford West Bloomfield Med Ctr
West Bloomfield, MI 48322-3013
Phone (248) 661-4100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Jan 11, 2022 Accepting new patients
Taylor Urgent Care PC CurrentSince Dec 1, 2020 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Jan 11, 2022 Accepting new patients
Farmington Hills Urgent Care Walk-in Clinic PC PastSince Jul 31, 2022 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1961 S Telegraph Rd
Bloomfield Township, MI 48302
Phone (248) 319-6190

2799 W Grand Blvd
#K12
Detroit, MI 48202
Phone (313) 876-2185

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2799 W Grand Blvd
#363
Detroit, MI 48202
Phone (313) 916-2020

23234 Ecorse Rd
Taylor, MI 48180
Phone (313) 292-8400

Interoperability endpoints

  • Direct secure messaging: alondon763047@direct.hfhs.org

Organizations & group practices 14

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.

View all 14

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": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1508461047",
    "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": "313-916-2181",
            "fax_number": "313-916-2478"
        },
        {
            "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": "313-916-2181",
            "fax_number": "313-916-2478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1961 S Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Bloomfield Hills",
            "state": "MI",
            "postal_code": "483020246",
            "country_code": "US",
            "telephone_number": "248-319-6160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYONE",
        "first_name": "ABIGAIL",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.