Individual provider Active NPI

Leena Ammori, PA-C

  • Physician Assistant
  • Dearborn, MI
National Provider Identifier
1831674399
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008859 Issued in MI
Practice address
2454 Monroe St Ste a
Dearborn, MI 48124-3038
Phone
(313) 562-4100
NPI assigned
Oct 1, 2018
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

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
I20190708001962 MI Practitioner - Physician Assistant 5294060612 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Jun 1, 2019 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Jun 1, 2019 Accepting new patients
Danny Kewson M.D. P.C PastSince Dec 13, 2020 Accepting new patients

Locations

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008859 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

2454 Monroe St Ste a
Dearborn, MI 48124-3038

Mailing address

2103 Bel Aire
West Bloomfield, MI 48323-1909

Other practice location 1

1030 Harrington St Ste 301
Mount Clemens, MI 48043-2967
Phone (586) 961-6060

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 10, 2020.

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1831674399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 BEL AIRE",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483231909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2454 MONROE ST STE A",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243038",
            "telephone_number": "313-562-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 Harrington St Ste 301",
            "address_purpose": "LOCATION",
            "city": "Mount Clemens",
            "state": "MI",
            "postal_code": "480432967",
            "country_code": "US",
            "telephone_number": "586-961-6060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMMORI",
        "first_name": "LEENA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.