Individual provider Active NPI

Iman Chamas, PA-C

  • Physician Assistant
  • Owosso, MI
National Provider Identifier
1821544081
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007905 Issued in MI
Practice address
200 Health Park Dr
Owosso, MI 48867-1291
Phone
(989) 723-8666
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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 MC4600816 AZ
Physician Assistant 363A00000X 5601007905 MI Primary

Addresses

Primary practice location

200 Health Park Dr
Owosso, MI 48867-1291

Mailing address

200 Health Park Dr
Owosso, MI 48867-1291
Phone (989) 723-8666

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
I20160923000053 MI Practitioner - Physician Assistant 3577850247 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6800 E 10 Mile Rd
Center Line, MI 48015-1167

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601007905MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intercare Community Health Network CurrentSince Mar 1, 2023 Accepting new patients
Intercare Community Health Network CurrentSince Mar 1, 2023 Accepting new patients
Associates in Primary Care, PLC CurrentSince Feb 2, 2026 Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients

Locations

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

650 E Big Beaver Rd
Ste A
Troy, MI 48083
Phone (248) 663-4401

Organizations & group practices 9

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1821544081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HEALTH PARK DR",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671291",
            "telephone_number": "989-723-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HEALTH PARK DR",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671291",
            "telephone_number": "989-723-8666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMAS",
        "first_name": "IMAN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "MC4600816",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owosso, MI

Sources for this page

Verify at the official NPI Registry.