Kailey Evasic, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601011330 Issued in MI

Practice address

55840 Grand River Ave Ste 300
New Hudson, MI 48165-9717

Phone

(248) 264-6169

NPI assigned

Nov 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians

Orthopedic Specialists of Oakland County PCGroup PAC ID 1153343504, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

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.

• Henry Ford Health Providence Hospital

  • Surgery Physician
  • Southfield, MI
  • NPI 1942265236
  Medicare reassignment Care Compare group
• Orthopedic Specialists of Oakland County, P.C.

  • Orthopaedic Surgery Physician
  • Bloomfield Hills, MI
  • NPI 1720200140
  Medicare reassignment Care Compare group
• Ascension Providence Hosptial

  • Internal Medicine Physician
  • Brighton, MI
  • NPI 1053684647
  NPD
• Henry Ford Health Providence Hospital

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1265497226
  NPD
• Henry Ford Cornerstone Medical Group

  • Family Medicine Physician
  • Clinton Township, MI
  • NPI 1851765374
  NPD (past)
• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1649987488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 WESTBROOKE DR",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781667",
            "telephone_number": "248-504-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55840 GRAND RIVER AVE STE 300",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "481659717",
            "telephone_number": "248-264-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVASIC",
        "first_name": "KAILEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601011330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Curtiss, RD
• Kimberly Cushman
• Danielle R. Ruskin DDS PLLC
• Emily P Dennis, PA-C
• Demi Anne Devenny, LPC
• Kristin Lee Frederick, MSW
• Devon Gilbert
• Grace OT LLC
• Kathleen Grace, MS OTR
• Grand River Medical Associates, PLLC

• Medical Physician Assistant in New Hudson, MI
• Providers in New Hudson, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.