Individual provider Active NPI

Thomas Sheppard

  • Medical Physician Assistant
  • Brighton, MI
National Provider Identifier
1629740170
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601010743 Issued in MI
Practice address
2305 Genoa Business Park Dr Ste 170
Brighton, MI 48114-7005
Phone
(810) 299-8554
NPI assigned
Oct 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601010743 MI Primary

Addresses

Primary practice location

2305 Genoa Business Park Dr Ste 170
Brighton, MI 48114-7005

Mailing address

2305 Genoa Business Park Dr Ste 170
Brighton, MI 48114-7005
Phone (810) 299-8554

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
I20220214002027 MI Practitioner - Physician Assistant 2365835469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedic Specialists, PCGroup PAC ID 4981697976, 11 clinicians

Practice addresses (Care Compare)

2305 Genoa Business Park Dr
Suite 170
Brighton, MI 48114-7005
Phone (810) 299-8550

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedic Specialists PC PastSince Feb 27, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tsheppard1151119@direct.hfhs.org

Organizations & group practices 2

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 4

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": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1629740170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 GENOA BUSINESS PARK DR STE 170",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147005",
            "telephone_number": "810-299-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 GENOA BUSINESS PARK DR STE 170",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147005",
            "telephone_number": "810-299-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-04",
        "last_updated": "2022-02-25",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601010743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.