Individual provider Active NPI

Paige Grace Burnham

  • Medical Physician Assistant
  • Saint Clair Shores, MI
National Provider Identifier
1508632068
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
24400 Greater Mack Ave
Saint Clair Shores, MI 48080-1340
Phone
(586) 778-1881
NPI assigned
Nov 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MI Primary

Addresses

Primary practice location

24400 Greater Mack Ave
Saint Clair Shores, MI 48080-1340

Mailing address

24400 Greater Mack Ave
Saint Clair Shores, MI 48080-1340

Other names 1

  • Paige Grace Sand 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
I20240617001450 MI Practitioner - Physician Assistant 3476096694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Waypointe Internal Medicine, P.C.Group PAC ID 8426021866, 5 clinicians

Practice addresses (Care Compare)

24400 Greater Mack Ave
Saint Clair Shores, MI 48080-1340
Phone (586) 778-1881

Hospital & facility affiliations

  • Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth Dziuba MD PC PastSince Jun 2, 2024 Accepting new patients

Organizations & group practices 2

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 3

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": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1508632068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24400 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24400 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801340",
            "telephone_number": "586-778-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNHAM",
        "first_name": "PAIGE",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAIGE",
            "last_name": "SAND",
            "middle_name": "GRACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.