Individual provider Active NPI

Alexandra Lee Scott, PA

  • Physician Assistant
  • Ann Arbor, MI
National Provider Identifier
1629285523
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004008 Issued in MI
Practice address
1500 E Medical Center Dr
B1 Floor Taumban Center Recp Mos
Ann Arbor, MI 48109-5317
Phone
(734) 232-2867
NPI assigned
May 17, 2007
Reactivated
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601004008 MI Primary
Medical Physician Assistant 363AM0700X 5601004008 MI

Addresses

Primary practice location

1500 E Medical Center Dr
B1 Floor Taumban Center Recp Mos
Ann Arbor, MI 48109-5317

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080930000797 MI Practitioner - Physician Assistant 6608944897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1801 Briarwood Cir
Ann Arbor, MI 48108-3347
Phone (734) 539-5000

19900 Haggerty Rd
Livonia, MI 48152-1054
Phone (734) 936-4000

2850 S Industrial Hwy
Ann Arbor, MI 48104-6796
Phone (734) 936-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601004008MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Physician Assistant CurrentSince Mar 6, 2012 Accepting new patients
Regents of the University of Michigan CurrentSince Mar 6, 2012 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1801 Briarwood Cir
Ann Arbor, MI 48108
Phone (734) 539-5000

3621 S State St
#700
Ann Arbor, MI 48108

1500 E Medical Center Dr
Fl Taumban
Ann Arbor, MI 48109
Phone (734) 232-2867

19900 Haggerty Rd
Ste 106
Livonia, MI 48152
Phone (734) 432-7870

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.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1629285523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "address_2": "B1 FLOOR TAUMBAN CENTER RECP MOS",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095317",
            "telephone_number": "734-232-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "ALEXANDRA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2012-03-05",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004008",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.