Amy Lee Staubach, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008700 Issued in MI

Practice address

15855 19 Mile Rd
Clinton TWP, MI 48038-3504

Phone

(586) 263-2300

NPI assigned

Jun 7, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Macomb Hospital CorporationGroup PAC ID 7911808381, 349 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: astaubach333516@direct.hfhs.org

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.

• Henry Ford Macomb Hospital Corporation

  • Family Medicine Physician
  • Clinton TWP, MI
  • NPI 1134265986
  Medicare reassignment Care Compare group
• Henry Ford Health System

  • Physician Assistant
  • Detroit, MI
  • NPI 1811073901
  Medicare reassignment NPD
• Wa Foote Memorial Hospital, Inc

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  NPD
• Henry Ford Macomb Hospital Corporation

  • Physician Assistant
  • Clinton TWP, MI
  • NPI 1124421888
  NPD
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735
  Care Compare affiliation

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1760975528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5300 Elliott Dr",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "48197",
            "country_code": "US",
            "telephone_number": "734-434-6262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAUBACH",
        "first_name": "AMY",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "astauba1@hfhs.org",
            "affiliation": "N",
            "address_1": "15855 19 Mile Rd",
            "city": "Clinton Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480383504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "astauba1@hfhs.org",
            "affiliation": "N",
            "address_1": "15855 19 Mile Rd",
            "city": "Clinton Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480383504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christy L Stamper, LLMSW
• Haley Stanbury
• Stanley L Engelhardt, MD, PC
• John Stanley, M.D.
• Catherine Mary Stanziola, LMSW
• Stay at Home Senior Care1
• Mackenzie Steele, LMSW
• Steffens Consulting, Inc.
• John Charles Steinhebel II
• Step Forward

• Physician Assistant in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.