Individual provider Active NPI

Miranda Sattam, PA-C

  • Physician Assistant
  • Livonia, MI
National Provider Identifier
1811672405
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9216 Middlebelt Rd
Livonia, MI 48150-4036
Phone
(734) 427-3500
NPI assigned
Jun 20, 2023
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 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 Primary

Addresses

Primary practice location

9216 Middlebelt Rd
Livonia, MI 48150-4036

Mailing address

9216 Middlebelt Rd
Livonia, MI 48150-4036

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
I20231019000887 MI Practitioner - Physician Assistant 1951757459 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: miranda.sattam.1@13339.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1811672405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9216 MIDDLEBELT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481504036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9216 MIDDLEBELT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481504036",
            "telephone_number": "734-427-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATTAM",
        "first_name": "MIRANDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.