Active NPI
Samantha Broomhead, PA
- Physician Assistant
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601003366
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2689 - Phone
- (313) 916-2600
- NPI assigned
- Mar 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601003366 | MI | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2689
Mailing address
11061 Bedford Dr
Sterling Heights, MI 48313-4001
Phone (586) 484-8458
Other practice location 1
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3137
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | SBroomh2@hfhs.org | ||
| Direct Messaging Address | sbroomhead522080@direct.hfhs.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
Hospital & facility affiliations
- Henry Ford Health Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003366 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health Providence Hospital | Current | Accepting new patients | |
| Henry Ford Health Providence Hospital | Current | Accepting new patients | |
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Health System | Physician Assistant | Current | Accepting new patients |
Locations
1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100
3601 W 13 Mile Rd
#400
Royal Oak, MI 48073
Phone (248) 423-2481
16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000
Interoperability endpoints
- sbroomh2@hfhs.org
Organizations & group practices 7
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.
-
- Physician Assistant
- Detroit, MI
- NPI 1811073901
-
- Surgery Physician
- Southfield, MI
- NPI 1942265236
-
- Emergency Medical Services (Emergency Medicine) Physician
- Southfield, MI
- NPI 1780791343
-
- Emergency Medical Services (Emergency Medicine) Physician
- Southfield, MI
- NPI 1700119500
-
- Pediatrics Physician
- Southfield, MI
- NPI 1265497226
-
- Internal Medicine Physician
- Southfield, MI
- NPI 1922063213
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652918400000",
"number": "1598733180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11061 BEDFORD DR",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483134001",
"telephone_number": "586-484-8458"
},
{
"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": "482022689",
"telephone_number": "313-916-2600"
}
],
"practiceLocations": [
{
"address_1": "16001 W 9 Mile Rd",
"address_purpose": "LOCATION",
"city": "Southfield",
"state": "MI",
"postal_code": "480754818",
"country_code": "US",
"telephone_number": "248-849-3137",
"fax_number": "248-849-2052",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROOMHEAD",
"first_name": "SAMANTHA",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-09",
"last_updated": "2022-05-19",
"certification_date": "2021-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601003366",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "SBroomh2@hfhs.org",
"affiliation": "N",
"address_1": "2799 W Grand Blvd",
"city": "Detroit",
"state": "MI",
"country_code": "US",
"postal_code": "482022689",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sbroomhead522080@direct.hfhs.org",
"affiliation": "N",
"address_1": "2799 W Grand Blvd",
"city": "Detroit",
"state": "MI",
"country_code": "US",
"postal_code": "482022689",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.