Individual provider Active NPI

Heather M Trudeau, PA

  • Physician Assistant
  • East Lansing, MI
National Provider Identifier
1790859858
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004905 Issued in MI
Practice address
4660 S Hagadorn Rd Ste 600
East Lansing, MI 48823-5383
Phone
(517) 355-4205
Fax
(517) 355-4202
NPI assigned
Nov 20, 2006
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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 5601004905 MI Primary

Addresses

Primary practice location

4660 S Hagadorn Rd Ste 600
East Lansing, MI 48823-5383

Mailing address

804 Service Rd Ste A202
East Lansing, MI 48824-7015
Phone (517) 355-4205

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
I20141023001745 MI Practitioner - Physician Assistant 4284855867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Msu Health Care Inc.Group PAC ID 8628404936, 201 clinicians

Practice addresses (Care Compare)

4660 S Hagadorn Rd
East Lansing, MI 48823-5353

4660 S Hagadorn Rd
Suite 500
East Lansing, MI 48823-6804
Phone (517) 884-4554

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Msu Health Care Inc. Physician Assistant CurrentSince Jan 1, 2023 Accepting new patients
Msu Health Care Inc. CurrentSince Jan 1, 2023 Accepting new patients
Msu Health Care Inc. Past Accepting new patients

Locations

4650 S Hagadorn Rd
Ste 100
East Lansing, MI 48823
Phone (517) 353-4830

4660 S Hagadorn Rd
Ste 210
East Lansing, MI 48823
Phone (517) 353-3102

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

4660 S Hagadorn Rd
Ste 600
East Lansing, MI 48823
Phone (517) 267-2460

804 Service Rd
Ste A109B
East Lansing, MI 48824
Phone (517) 884-2976

804 Service Rd
Ste A202
East Lansing, MI 48824
Phone (517) 884-2976

Interoperability endpoints

  • Direct secure messaging: heather.trudeau.1@13693.direct.athenahealth.com
  • Direct secure messaging: heather.trudeau.1@25394.direct.athenahealth.com

Organizations & group practices 4

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 4

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1790859858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A202",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-355-4205",
            "fax_number": "517-355-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 S HAGADORN RD STE 600",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235383",
            "telephone_number": "517-355-4205",
            "fax_number": "517-355-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUDEAU",
        "first_name": "HEATHER",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.