Amber Imani Hogan, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

861 Health Park Blvd
Grand Blanc, MI 48439-7383

Phone

(810) 953-0500

Fax

(810) 953-0031

NPI assigned

Nov 25, 2019

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Amber McCoy Former name

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

Specialty

Physician Assistant

Education

University of Toledo College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ieppc Urgent Care PLLCGroup PAC ID 9032448766, 20 clinicians

Summit Regenerative HealthGroup PAC ID 6406295849, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: amberhogan@gmoortho.directglo.com

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.

• Ieppc Urgent Care PLLC

  dba Iep Urgent Care

  • Urgent Care Clinic/Center
  • Novi, MI
  • NPI 1689235897
  Medicare reassignment Care Compare group
• Summit Regenerative Health

  • Chiropractor
  • Waterford, MI
  • NPI 1518734797
  Medicare reassignment Care Compare group
• Iep Mco Orthopedic Urgent Care PLLC

  • Orthopaedic Surgery Physician
  • Bloomfield Hills, MI
  • NPI 1366240236
  Medicare reassignment
• Ortho Xpress PLLC

  • Orthopaedic Surgery Physician
  • Grand Blanc, MI
  • NPI 1396334983
  Medicare reassignment

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1558907519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 HEALTH PARK BLVD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397383",
            "telephone_number": "810-953-0500",
            "fax_number": "810-953-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 HEALTH PARK BLVD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397383",
            "telephone_number": "810-953-0500",
            "fax_number": "810-953-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "AMBER",
        "middle_name": "IMANI",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2023-03-07",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "13262",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "5601009493",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "MCCOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rhonda Hodges
• Kathrine Hodgins
• Abigail Hoffman, PA-C
• Lauren Anne Hoffmann, B.S
• Jessica Lynn Hoffstatter, DPM
• Missy T Hogmire
• Holistic Physical Therapy Clinic
• Linda Ann Hollern, NP
• Holly Family Medicine PLC
• Jalynn Holmes

• Physician Assistant in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.