Deanna Grifka, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004096 Issued in MI

Practice address

11900 E 12 Mile Rd
Suite # 111
Warren, MI 48093-3400

Phone

(586) 573-5300

Fax

(586) 573-5304

NPI assigned

Jun 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Deanna Dakroub Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

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  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1689611402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 E 12 MILE RD",
            "address_2": "SUITE # 111",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933400",
            "telephone_number": "586-573-5300",
            "fax_number": "586-573-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 E 12 MILE RD",
            "address_2": "SUITE # 111",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933400",
            "telephone_number": "586-573-5300",
            "fax_number": "586-573-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFKA",
        "first_name": "DEANNA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103122",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29Z314900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "M57830007",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292314900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "DAKROUB",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Quanesha Grier
• Shameka D Griffin
• Shavonte Griffin
• Jason Howard Griffith, D.O.
• Sarah Linnae Griffith, D.O.
• Bradley L Grincewicz, PA-C
• Angjela Grishaj
• Endrit Gropcaj, PHARMD
• Harjot Kaur Grover, D.O.
• Regina V. Grujovski, LMFT

• Physician Assistant in Warren, MI
• Providers in Warren, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.