Individual provider Active NPI

Randy C Stapish, PA-C

  • Physician Assistant
  • Dearborn Heights, MI
National Provider Identifier
1659490464
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
RS001463 Issued in MI
Practice address
8623 N Telegraph Rd
Suite # 1
Dearborn Heights, MI 48127-1489
Phone
(313) 561-4540
Fax
(313) 561-9515
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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 RS001463 MI Primary

Addresses

Primary practice location

8623 N Telegraph Rd
Suite # 1
Dearborn Heights, MI 48127-1489

Mailing address

8623 N Telegraph Rd
Suite # 1
Dearborn Heights, MI 48127-1489
Phone (313) 561-4540

Other practice location 1

22711 Grand River Ave
Detroit, MI 48219-3113
Phone (313) 221-9189

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
I20070926000351 MI Practitioner - Physician Assistant 0749374429 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Medical Centre PCGroup PAC ID 5597668947, 13 clinicians

Practice addresses (Care Compare)

22711 Grand River Ave
Suite 100
Detroit, MI 48219-3113
Phone (313) 221-9189

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RS001463MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kamran F. Sheikh MD PC CurrentSince Jan 1, 2026 Accepting new patients

Locations

22711 Grand River Ave
#100
Detroit, MI 48219
Phone (313) 221-9189

22711 Grand River Ave
Ste 100
Detroit, MI 48219
Phone (313) 221-9189

29201 Telegraph Rd
Ste 404
Southfield, MI 48034
Phone (248) 355-0880

Interoperability endpoints

  • Direct secure messaging: randy.stapish.1@22774.direct.athenahealth.com
  • Direct secure messaging: randy.stapish.1@24172.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1659490464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8623 N TELEGRAPH RD",
            "address_2": "SUITE # 1",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271489",
            "telephone_number": "313-561-4540",
            "fax_number": "313-561-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8623 N TELEGRAPH RD",
            "address_2": "SUITE # 1",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271489",
            "telephone_number": "313-561-4540",
            "fax_number": "313-561-9515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22711 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482193113",
            "country_code": "US",
            "telephone_number": "313-221-9189",
            "fax_number": "313-766-5876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAPISH",
        "first_name": "RANDY",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "RS001463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.