Individual provider Active NPI

Maya Harp, PA-C

  • Physician Assistant
  • Canton, MI
National Provider Identifier
1710216502
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005631 Issued in MI
Practice address
7025 N Lilley Rd
Canton, MI 48187-3533
Phone
(954) 377-2939
NPI assigned
Dec 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 58779 CA
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 5601005631 MI Primary

Addresses

Primary practice location

7025 N Lilley Rd
Canton, MI 48187-3533

Mailing address

6755 Tiffany Cir
Canton, MI 48187-5260
Phone (313) 516-8761

Other practice location 1

7858 Honors Ct
Pleasanton, CA 94588-3108
Phone (313) 516-8761

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
I20110708000313 MI Practitioner - Physician Assistant 0042498354 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58779CAMDDentist
5601005631MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
NV Pacs 2 LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1710216502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6755 TIFFANY CIR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481875260",
            "telephone_number": "313-516-8761",
            "fax_number": "313-516-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7025 N LILLEY RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873533",
            "telephone_number": "954-377-2939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7858 Honors Ct",
            "address_purpose": "LOCATION",
            "city": "Pleasanton",
            "state": "CA",
            "postal_code": "945883108",
            "country_code": "US",
            "telephone_number": "313-516-8761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARP",
        "first_name": "MAYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-08",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "58779",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.