Individual provider Active NPI

Alison Yasuyo Weidel, PA

  • Physician Assistant
  • West Bloomfield, MI
National Provider Identifier
1669820544
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011669 Issued in MI
Practice address
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone
(248) 325-0636
NPI assigned
Jun 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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 PA2017-0098 NM
Physician Assistant 363A00000X 5601011669 MI Primary

Addresses

Primary practice location

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Mailing address

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 325-0636

Other practice location 1

630 W Maple St
Farmington, NM 87401-6113
Phone (505) 609-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, 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
I20171215000749 NM Practitioner - Physician Assistant 7113285370 Reassigns benefits to 1 organization
I20231024000415 MI Practitioner - Physician Assistant 7113285370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
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)

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

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601011669MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Physician Assistant CurrentSince Oct 20, 2023 Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Dec 12, 2017 Accepting new patients
San Juan Regional Medical Center Inc CurrentSince Dec 12, 2017 Accepting new patients
Henry Ford Health System CurrentSince Oct 20, 2023 Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients

Locations

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

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

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

407 S Schwartz Ave
Ste 201
Farmington, NM 87401
Phone (505) 609-6300

630 W Maple St
Farmington, NM 87401
Phone (505) 325-1123

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

Interoperability endpoints

  • Direct secure messaging: aweidel889591@direct.hfhs.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 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": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1669820544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "248-325-0636",
            "fax_number": "248-325-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "248-325-0636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 W Maple St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874016113",
            "country_code": "US",
            "telephone_number": "505-609-6300",
            "fax_number": "505-609-6301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIDEL",
        "first_name": "ALISON",
        "middle_name": "YASUYO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2017-0098",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.