NPIMap

Individual provider Active NPI

Tara Melissa Way, PA-C

  • Physician Assistant
  • Wayne, MI
National Provider Identifier
1558611491
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
34841 Veterans PLZ
Wayne, MI 48184-1733
Phone
(734) 728-3446
NPI assigned
Sep 18, 2012
Last updated
Nov 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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 MI Primary

Addresses

Primary practice location

34841 Veterans PLZ
Wayne, MI 48184-1733

Mailing address

34841 Veterans PLZ
Wayne, MI 48184-1733
Phone (734) 728-3446

Other names 1

  • Mrs. Tara M Way Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130117000213 MI Practitioner - Physician Assistant 9830342104 Reassigns benefits to 4 organizations
I20250411000910 SC Practitioner - Physician Assistant 9830342104 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4968SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Michigan PC CurrentSince Feb 4, 2019 Accepting new patients
Seton Health Corporation of Southeastern Michigan CurrentSince Jul 1, 2014 Accepting new patients
Geriatric Psychiatric Services PLLC Past Accepting new patients
Ferndale Urgent Care Past Accepting new patients
New Center Community Mental Health Services PastSince Sep 2, 2008 Accepting new patients
New Center Community Mental Health Services Past Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients
Waterford Urgent Care PC Past Accepting new patients

Locations

436 44th St SE
Ste A
Kentwood, MI 49548
Phone (616) 531-9750

22255 Greenfield Rd
Ste 550
Southfield, MI 48075
Phone (586) 226-6161

11569 E 12 Mile Rd
Warren, MI 48093
Phone (586) 582-0018

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1558611491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34841 VETERANS PLZ",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841733",
            "telephone_number": "734-728-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34841 VETERANS PLZ",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841733",
            "telephone_number": "734-728-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAY",
        "first_name": "TARA",
        "middle_name": "MELISSA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "WAY",
            "middle_name": "M",
            "prefix": "MRS.",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wayne, MI

Sources for this page

Verify at the official NPI Registry.