Individual provider Active NPI

Amanda Michelle Vetere, PA-C

  • Physician Assistant
  • Brighton, MI
National Provider Identifier
1689812323
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005194 Issued in MI
Practice address
2305 Genoa Business Park Dr
Suite 170
Brighton, MI 48114-7004
Phone
(810) 299-8550
NPI assigned
Feb 3, 2009
Last updated
Feb 3, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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 5601005194 MI Primary

Addresses

Primary practice location

2305 Genoa Business Park Dr
Suite 170
Brighton, MI 48114-7004

Mailing address

2372 Sun Valley Dr
Ann Arbor, MI 48108-9699
Phone (734) 945-5507

Other names 1

  • Miss Amanda Michelle Spyker Former name

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
I20090409000289 MI Practitioner - Physician Assistant 5698822641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Mercy HospitalGroup PAC ID 3779489281, 69 clinicians

Practice addresses (Care Compare)

5301 E Huron River Dr
Ann Arbor, MI 48197-1051
Phone (734) 712-3456

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601005194MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Mercy Livingston Hospital CurrentSince Oct 31, 2023 Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Oct 31, 2023 Accepting new patients
St Joseph Mercy Hospital Physician Assistant CurrentSince Sep 14, 2011 Accepting new patients
St Joseph Mercy Hospital CurrentSince Sep 14, 2011 Accepting new patients
Advanced Orthopedic Specialists PC Past Accepting new patients

Locations

2305 Genoa Business Park Dr
Ste 170
Brighton, MI 48114
Phone (810) 299-8550

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

5333 McAuley Dr
Rm 4001
Ypsilanti, MI 48197
Phone (734) 712-3376

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1689812323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2372 SUN VALLEY DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481089699",
            "telephone_number": "734-945-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 GENOA BUSINESS PARK DR",
            "address_2": "SUITE 170",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147004",
            "telephone_number": "810-299-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETERE",
        "first_name": "AMANDA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-03",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "SPYKER",
            "middle_name": "MICHELLE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.