Individual provider Active NPI

Megan Patricia Doulette, PA

  • Physician Assistant
  • Commerce Township, MI
National Provider Identifier
1649734633
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 William Carls Dr # 120
Commerce Township, MI 48382-2201
Phone
(248) 937-4947
NPI assigned
Jan 24, 2019
Last updated
Jan 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1 William Carls Dr # 120
Commerce Township, MI 48382-2201

Mailing address

10183 Longford Dr
South Lyon, MI 48178-8503
Phone (734) 536-3660

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
I20190319001960 MI Practitioner - Physician Assistant 6507106150 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians
Iha Olma Specialty 1 LLCGroup PAC ID 6901206689, 67 clinicians

Practice addresses (Care Compare)

19000 St Joes Pkwy
Livonia, MI 48152-1477

36475 5 Mile Rd
Livonia, MI 48154-1971
Phone (734) 583-9125

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5315 Elliott Dr
Suite 301
Ypsilanti, MI 48197-8634
Phone (866) 678-4644

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Olma Specialty 1 LLC CurrentSince Nov 1, 2022 Accepting new patients
Iha Olma Specialty 1 LLC CurrentSince Nov 1, 2022 Accepting new patients
Straith Hospital for Special Surgery Past Accepting new patients

Locations

2305 Genoa Business Park Dr
Ste 120
Brighton, MI 48114
Phone (810) 494-6881

19000 St Joes Pkwy
Ste 210
Livonia, MI 48152
Phone (734) 655-8250

Interoperability endpoints

  • Direct secure messaging: mdoulette1624302@direct.trinity-health.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1649734633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10183 LONGFORD DR",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481788503",
            "telephone_number": "734-536-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WILLIAM CARLS DR # 120",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483822201",
            "telephone_number": "248-937-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOULETTE",
        "first_name": "MEGAN",
        "middle_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce Township, MI

Sources for this page

Verify at the official NPI Registry.