Individual provider Active NPI

Elizabeth Ann Denardis, PA

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1659785491
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006995 Issued in MI
Practice address
6071 W Outer Dr
Detroit, MI 48235-2624
Phone
(313) 966-4954
NPI assigned
Jun 19, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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 5601006995 MI Primary

Addresses

Primary practice location

6071 W Outer Dr
Detroit, MI 48235-2624

Mailing address

6071 W Outer Dr
Detroit, MI 48235-2624
Phone (313) 966-4954

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
I20180220003258 MI Practitioner - Physician Assistant 0244591964 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

Hospital & facility affiliations

  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Feb 1, 2018 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Mar 1, 2018 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Feb 1, 2018 Accepting new patients
Michigan Healthcare Professionals, P.C. CurrentSince Mar 1, 2018 Accepting new patients
Henry Ford Health Macomb Oakland Hospital Physician Assistant CurrentSince Dec 1, 2020 Accepting new patients

Locations

42557 Woodward Ave
Ste 200
Bloomfield Hills, MI 48304
Phone (248) 322-0083

42557 Woodward Ave
Ste 130
Bloomfield Hills, MI 48304
Phone (248) 322-3088

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

27483 Dequindre Rd
Ste 204
Madison Hts, MI 48071
Phone (248) 967-7326

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

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 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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1659785491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-4954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-4954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENARDIS",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.