Individual provider Active NPI

Tessa Marie Mac

  • Physician Assistant
  • Ann Arbor, MI
National Provider Identifier
1720536360
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007962 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Sep 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 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 MI
Physician Assistant 363A00000X 5601007962 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

451 Hidden Meadows Dr Ste 260
Hillsdale, MI 49242-9812
Phone (517) 437-5350

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
I20161108002012 MI Practitioner - Physician Assistant 8527347905 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

1801 Briarwood Cir
Ann Arbor, MI 48108-3347
Phone (734) 539-5000

7500 Challis Rd
Brighton, MI 48116-9416
Phone (810) 263-4000

8001 Challis Rd
Brighton, MI 48116-7446
Phone (810) 227-9510

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Feb 14, 2023 Accepting new patients
Hillsdale Community Health Center CurrentSince May 15, 2019 Accepting new patients
Bronson Battle Creek Hospital Physician Assistant CurrentSince Nov 4, 2016 Accepting new patients
Hillsdale Community Health Center CurrentSince May 15, 2019 Accepting new patients
Regents of the University of Michigan Physician Assistant CurrentSince Feb 14, 2023 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1801 Briarwood Cir
Ann Arbor, MI 48108
Phone (734) 539-5000

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

710 North Ave
Battle Creek, MI 49017
Phone (269) 704-3133

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

7500 Challis Rd
Brighton, MI 48116
Phone (734) 764-4190

14650 E Old US Highway 12
Chelsea, MI 48118
Phone (734) 475-2600

451 Hidden Meadows Dr
Ste 290
Hillsdale, MI 49242
Phone (269) 226-5050

168 S Howell St
Hillsdale, MI 49242
Phone (517) 437-4451

451 Hidden Meadows Dr
Ste 260
Hillsdale, MI 49242
Phone (269) 969-6196

Organizations & group practices 7

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": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1720536360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "451 Hidden Meadows Dr Ste 260",
            "address_purpose": "LOCATION",
            "city": "Hillsdale",
            "state": "MI",
            "postal_code": "492429812",
            "country_code": "US",
            "telephone_number": "517-437-5350",
            "fax_number": "517-437-8328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAC",
        "first_name": "TESSA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.