Individual provider Active NPI

Sara Eileen Eadie, D.O.

  • Emergency Medicine Physician
  • Warren, MI
National Provider Identifier
1851545255
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
AB31053220214 Issued in MI
Practice address
13355 E 10 Mile Rd
Warren, MI 48089-2048
Phone
(586) 759-7960
NPI assigned
Nov 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X AB31053220214 MI Primary

Addresses

Primary practice location

13355 E 10 Mile Rd
Warren, MI 48089-2048

Mailing address

7 N Squirrel Rd
Auburn Hills, MI 48326-4002
Phone (248) 227-2252

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120627000207 MI Practitioner - Emergency Medicine 3678738572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Michigan Observation Services PLLCGroup PAC ID 3375938889, 30 clinicians

Practice addresses (Care Compare)

1500 E Sherman Blvd
Mercy Health
Muskegon, MI 49444-1849
Phone (231) 728-4601

Hospital & facility affiliations

  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
  • Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174
  • Mercy Health Lakeshore Campus Hospital, Shelby, MI, CCN 231320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
AB31053220214MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Michigan Observation Services PLLC CurrentSince Jan 1, 2022 Accepting new patients
Lake Michigan Emergency Specialists, PLLC Emergency Medicine CurrentSince Jan 1, 2017 Accepting new patients
Emergency Health Partners-Lakeshore, PLC Emergency Medicine Past Accepting new patients

Locations

1309 Sheldon Rd
Grand Haven, MI 49417
Phone (616) 842-3600

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

72 S State St
Shelby, MI 49455
Phone (231) 728-4601

Interoperability endpoints

  • Direct secure messaging: seadie23862@direct.trinity-health.org

Organizations & group practices 3

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 3

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": "1226361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1851545255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 N SQUIRREL RD",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483264002",
            "telephone_number": "248-227-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13355 E 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480892048",
            "telephone_number": "586-759-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EADIE",
        "first_name": "SARA",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-11",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "AB31053220214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.