Individual provider Active NPI

Ciara Brennan

  • Medical Physician Assistant
  • Farmington Hills, MI
National Provider Identifier
1629852603
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601011967 Issued in MI
Practice address
27303 Gateway Dr N Apt 11-303
Farmington Hills, MI 48334-4927
Phone
(508) 844-7118
NPI assigned
Aug 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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 5601011967 MI Primary

Addresses

Primary practice location

27303 Gateway Dr N Apt 11-303
Farmington Hills, MI 48334-4927

Mailing address

27303 Gateway Dr N Apt 11-303
Farmington Hills, MI 48334-4927
Phone (508) 844-7118

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
I20260120002781 MI Order and Referring Only - Physician Assistant 9739534181

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14671 Telegraph Rd
Redford, MI 48239-3300

95 W Main St
Suite 240
Chester, NJ 07930-2487

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601011967MIMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: ciara.brennan.1@27127.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1629852603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27303 GATEWAY DR N APT 11-303",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344927",
            "telephone_number": "508-844-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27303 GATEWAY DR N APT 11-303",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344927",
            "telephone_number": "508-844-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "CIARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601011967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.