Michelle De Varennes, M.S., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601010055 Issued in MI

Practice address

25311 Little Mack Ave Ste B
Saint Clair Shores, MI 48081-3301

Phone

(586) 498-2400

NPI assigned

Jun 24, 2020

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

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

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independent Observation Physicians PLLCGroup PAC ID 3577603604, 138 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
• Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195

Merit-based Incentive Payment System (MIPS)

Final score

94.92 of 100Reported as group

Quality

93.88

Improvement activities

40

Cost

69.43

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mdevarennes1124717@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 and National Provider Directory roles.

• Independent Observation Physicians PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1700119500
  Medicare reassignment Care Compare group
• Great Lakes Physiatrists PC

  • Physical Medicine & Rehabilitation Physician
  • St Clair Shores, MI
  • NPI 1811096548
  Medicare reassignment
• Independent Hospitalist Physicians, PLLC

  • Hospitalist Physician
  • Southfield, MI
  • NPI 1851820641
  Medicare reassignment
• Henry Ford Semi Medical Group

  • Endocrinology, Diabetes & Metabolism Physician
  • Novi, MI
  • NPI 1114133485
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Macomb Oakland Hospital

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1124099858
  Care Compare affiliation
• Henry Ford Health Macomb Oakland Hospital

  • General Acute Care Hospital
  • Madison Heights, MI
  • NPI 1215139233
  Care Compare affiliation
• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620518400000",
    "number": "1568088680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29938 MUIRLAND DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25311 LITTLE MACK AVE STE B",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813301",
            "telephone_number": "586-498-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Saint Antoine St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "313-745-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE VARENNES",
        "first_name": "MICHELLE",
        "credential": "M.S., PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2021-05-09",
        "certification_date": "2021-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Davis
• Thomas Patrick Davis, MD
• Bashar Joseph Dawood, MD
• Steven Joseph Dawood, M.D.
• Anna Maria F De Luna
• Olivia Debets
• Samantha Decker
• Jennifer Dees, LMSW
• Lynne Marie Degrande, MSW
• Jeffrey Scott Degroat, PH.D.

• Physician Assistant in Saint Clair Shores, MI
• Providers in Saint Clair Shores, 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 9, 2021; 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.