Individual provider Active NPI

Furva Merchant

  • Physician Assistant
  • Southfield, MI
National Provider Identifier
1811238124
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009727 Issued in MI
Practice address
28300 Franklin Rd Ste 100
Southfield, MI 48034-1657
Phone
(248) 973-3660
NPI assigned
Mar 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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 PA9106826 FL
Physician Assistant 363A00000X 5601009727 MI Primary

Addresses

Primary practice location

28300 Franklin Rd Ste 100
Southfield, MI 48034-1657

Mailing address

6981 Piazza St
Orlando, FL 32819-5289

Other practice location 1

58 W Michigan St
Orlando, FL 32806-4453
Phone (407) 650-9220

Other practice location 2

7588 Toscana Blvd Apt 424
Orlando, FL 32819-5524
Phone (407) 984-7803

Other practice location 3

6981 Piazza St
Orlando, FL 32819-5289
Phone (407) 371-1236

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
I20210813000680 MI Practitioner - Physician Assistant 8123328309 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Innovation Medicine, PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ortelellcasphysicianuniversepllc.furvamerchant@143718.advancedmd-direct.com

Organizations & group practices 2

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": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1811238124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6981 PIAZZA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28300 FRANKLIN RD STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341657",
            "telephone_number": "248-973-3660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58 W Michigan St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328064453",
            "country_code": "US",
            "telephone_number": "407-650-9220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7588 Toscana Blvd Apt 424",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328195524",
            "country_code": "US",
            "telephone_number": "407-984-7803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6981 Piazza St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328195289",
            "country_code": "US",
            "telephone_number": "407-371-1236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "FURVA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106826",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.