Individual provider Active NPI

Diane Marie Willman, PA

  • Physician Assistant
  • Lansing, MI
National Provider Identifier
1821022195
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003309 Issued in MI
Practice address
401 W Greenlawn Ave
Lansing, MI 48910-2819
Phone
(517) 975-9500
Fax
(517) 975-9511
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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 5601003309 MI Primary

Addresses

Primary practice location

401 W Greenlawn Ave
Lansing, MI 48910-2819

Mailing address

804 Service Rd
A201
East Lansing, MI 48824-7015
Phone (517) 884-2976

Other identifiers 1

IdentifierTypeStateIssuer
1821022195MedicaidMI

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
I20050809000825 MI Practitioner - Physician Assistant 7517996614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lansing Urgent Care PLCGroup PAC ID 7214947902, 42 clinicians

Practice addresses (Care Compare)

12970 S US Hwy 27
Dewitt, MI 48820-7956
Phone (517) 999-2273

320 E Jolly Rd
Lansing, MI 48910-6677
Phone (517) 999-4700

4440 W Saginaw Hwy
Lansing, MI 48917-2701
Phone (517) 327-6400

505 N Clippert St
Lansing, MI 48912-4701
Phone (517) 333-9200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lansing Urgent Care, PLC Past Accepting new patients

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1821022195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD",
            "address_2": "A201",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-2976",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W GREENLAWN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102819",
            "telephone_number": "517-975-9500",
            "fax_number": "517-975-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMAN",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821022195",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.