Individual provider Active NPI

Andrea G Ciaravino, PA-C

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1659522449
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007094 Issued in MI
Practice address
Herny Ford
2799 West Grand Blvd
Detroit, MI 48202
Phone
(313) 982-8241
NPI assigned
Oct 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007094 MI Primary
Surgical Physician Assistant 363AS0400X 5601007094 MI

Addresses

Primary practice location

Herny Ford
2799 West Grand Blvd
Detroit, MI 48202

Mailing address

19401 Hubbard Dr Ste 101
Dearborn, MI 48126-2641
Phone (313) 982-8241

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address aciaravino389973@direct.org
Direct Messaging Address aciaravino389973@direct.hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090112000231 NC Practitioner - Physician Assistant 8527121904
I20160211001540 MI Practitioner - Physician Assistant 8527121904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

19401 Hubbard Dr
Dearborn, MI 48126-2641
Phone (313) 982-8100

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601007094MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Feb 1, 2016 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Feb 1, 2016 Accepting new patients
Henry Ford Maplegrove Center PastSince Mar 16, 2021 Accepting new patients

Locations

19401 Hubbard Dr
Ste 101
Dearborn, MI 48126
Phone (313) 982-8241

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2799 W Grand Blvd
#363
Detroit, MI 48202
Phone (313) 916-2020

2799 W Grand Blvd
#K11
Detroit, MI 48202
Phone (313) 916-2241

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: aciaravino389973@direct.hfhs.org

Organizations & group practices 4

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": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1659522449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19401 HUBBARD DR STE 101",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262641",
            "telephone_number": "313-982-8241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HERNY FORD",
            "address_2": "2799 WEST GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-982-8241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIARAVINO",
        "first_name": "ANDREA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-10",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007094",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601007094",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aciaravino389973@direct.org",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aciaravino389973@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.