Individual provider Active NPI

Amanda Jane Paris, MD

  • Family Medicine Physician
  • Livonia, MI
National Provider Identifier
1619474459
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301505599 Issued in MI
Practice address
37595 7 Mile Rd Ste 230
Livonia, MI 48152-1003
Phone
(734) 853-5694
Fax
(734) 430-9388
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 4301505599 MI Primary

Addresses

Primary practice location

37595 7 Mile Rd Ste 230
Livonia, MI 48152-1003

Mailing address

37595 7 Mile Rd Ste 230
Livonia, MI 48152-1003
Phone (734) 853-5694

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211029000555 MI Practitioner - Family Practice 6406102532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mymichigan Medical GroupGroup PAC ID 4981501939, 174 clinicians

Practice addresses (Care Compare)

555 W Wackerly St
Suite 1600
Midland, MI 48640-4710
Phone (989) 839-8810

Hospital & facility affiliations

  • Mymichigan Home Care Home health agency, Midland, MI, CCN 237015
  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
  • Mymichigan Medical Center Clare Hospital, Clare, MI, CCN 230180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alpena CurrentSince Sep 19, 2021 Accepting new patients
Mymichigan Medical Group Family Medicine CurrentSince Sep 19, 2021 Accepting new patients
Mymichigan Medical Group Past Accepting new patients

Locations

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

555 W Wackerly St
Ste 1600
Midland, MI 48640
Phone (989) 374-0131

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

5785 E Broadway Rd
Mt Pleasant, MI 48858
Phone (989) 773-9421

Interoperability endpoints

  • Direct secure messaging: aparis114896@mymichiganhealth.midirect.net

Organizations & group practices 3

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 5

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1619474459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37595 7 MILE RD STE 230",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521003",
            "telephone_number": "734-853-5694",
            "fax_number": "734-430-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37595 7 MILE RD STE 230",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521003",
            "telephone_number": "734-853-5694",
            "fax_number": "734-430-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARIS",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301505599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.