Individual provider Active NPI

Gerard M Lefebvre Jr., PA-C

  • Surgical Physician Assistant
  • Ypsilanti, MI
National Provider Identifier
1841835303
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601009499 Issued in MI
Practice address
5301 McAuley Dr Ste 5112
Ypsilanti, MI 48197-1051
Phone
(734) 712-0478
Fax
(734) 712-2099
NPI assigned
Nov 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5601009499 MI Primary

Addresses

Primary practice location

5301 McAuley Dr Ste 5112
Ypsilanti, MI 48197-1051

Mailing address

5333 McAuley Dr RM 5112
Ypsilanti, MI 48197-1003
Phone (734) 712-0478

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
I20191122000562 MI Practitioner - Physician Assistant 0648602045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Mercy HospitalGroup PAC ID 3779489281, 69 clinicians

Practice addresses (Care Compare)

5301 E Huron River Dr
Ann Arbor, MI 48197-1051
Phone (734) 712-3456

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601009499MIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Mercy Hospital CurrentSince Nov 1, 2019 Accepting new patients
St Joseph Mercy Hospital Surgical CurrentSince Nov 1, 2019 Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Mar 1, 2020 Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients

Locations

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925

5301 McAuley Dr
Ste 5112
Ypsilanti, MI 48197
Phone (734) 712-0478

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

5333 McAuley Dr
Rm 5112
Ypsilanti, MI 48197
Phone (734) 712-0478

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1841835303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR RM 5112",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971003",
            "telephone_number": "734-712-0478",
            "fax_number": "734-712-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 MCAULEY DR STE 5112",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-0478",
            "fax_number": "734-712-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFEBVRE",
        "first_name": "GERARD",
        "middle_name": "M",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-08",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601009499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.