Individual provider Active NPI

Gabriella Anthi Thomas-Burde

  • Family Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1861066151
Registry record updated May 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704261563 Issued in MI
Practice address
30920 Southfield Rd # 8021
Southfield, MI 48076-7738
Phone
(248) 647-7472
NPI assigned
May 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704261563 MI Primary

Addresses

Primary practice location

30920 Southfield Rd # 8021
Southfield, MI 48076-7738

Mailing address

30920 Southfield Rd # 8021
Southfield, MI 48076-7738
Phone (248) 647-7472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220125000463 MI Practitioner - Nurse Practitioner 6406248459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.3 of 100Reported as group
Quality
76.96
Improvement activities
40
Cost
79.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704261563MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Feb 25, 2024 Accepting new patients

Locations

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 1

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": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653177600000",
    "number": "1861066151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30920 SOUTHFIELD RD # 8021",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480767738",
            "telephone_number": "248-647-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30920 SOUTHFIELD RD # 8021",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480767738",
            "telephone_number": "248-647-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS-BURDE",
        "first_name": "GABRIELLA",
        "middle_name": "ANTHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2022-05-22",
        "certification_date": "2022-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704261563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.