Amy Abdelnour Davisson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004912 Issued in MI

Practice address

15119 Woodward Ave
Highland Park, MI 48203-2907

Phone

(313) 865-2020

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Amy Marie Abdelnour Former name

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bloomfield Medical Center PLCGroup PAC ID 1153235742, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: amy.davisson.1@19270.direct.athenahealth.com

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.

• Bloomfield Medical Center PLC

  • Clinic/Center
  • Farmington Hills, MI
  • NPI 1265523328
  Medicare reassignment Care Compare group
• Jagneswar Saha DO PC

  • Health Service Clinic/Center
  • Highland Park, MI
  • NPI 1871638890
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1821178518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15119 WOODWARD AVE",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482032907",
            "telephone_number": "313-865-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15119 WOODWARD AVE",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482032907",
            "telephone_number": "313-865-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISSON",
        "first_name": "AMY",
        "middle_name": "ABDELNOUR",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "ABDELNOUR",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marina Shama Dahdolan
• Carina S Daniel
• Moumita Datta
• Carrie E Daugherty, FAODP
• Shelia Denise Davis, LPN
• Detroit Recovery Project
• Detroit Recovery Project, Incorporated
• Detroit Rescue Mission Ministries (Christian Guiadance Center)
• Detroit Rescue Mission Ministries (Christian Guidance Center)
• Detroit Rescue Mission Ministries Genesis House I II III & Oasis

• Physician Assistant in Highland Park, MI
• Providers in Highland Park, 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 22, 2016; 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.