Individual provider Active NPI

Julie Ann Baranowski, PA-C

  • Medical Physician Assistant
  • Detroit, MI
National Provider Identifier
1821386954
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601005999 Issued in MI
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 745-8040
Fax
(313) 745-9655
NPI assigned
Jul 11, 2011
Last updated
Oct 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601005999 MI Primary

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

3294 Gemini Dr
Sterling Heights, MI 48314-3175

Other practice location 1

6071 West Outer Drive
Sinai-Grace Hospital
Detroit, MI 48235
Phone (313) 966-3924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110831000063 MI Practitioner - Physician Assistant 6204006208 Reassigns benefits to 2 organizations
I20220316003363 LA Practitioner - Physician Assistant 6204006208 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601005999MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Medical CurrentSince Jan 8, 2019 Accepting new patients
Henry Ford Health System CurrentSince Jan 8, 2019 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

Interoperability endpoints

  • Direct secure messaging: jbaranow@direct.dmc.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1821386954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3294 GEMINI DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-8040",
            "fax_number": "313-745-9655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6071 West Outer Drive",
            "address_2": "Sinai-Grace Hospital",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48235",
            "country_code": "US",
            "telephone_number": "313-966-3924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARANOWSKI",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601005999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.