Individual provider Active NPI

Paula Jean Mass, PA

  • Medical Physician Assistant
  • Lansing, MI
National Provider Identifier
1861639502
Registry record updated Oct 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601002093 Issued in MI
Practice address
2815 S Pennsylvania Ave
Suite 105
Lansing, MI 48910-3495
Phone
(517) 975-9830
NPI assigned
Jan 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601002093 MI Primary

Addresses

Primary practice location

2815 S Pennsylvania Ave
Suite 105
Lansing, MI 48910-3495

Mailing address

2815 S Pennsylvania Ave
Suite 105
Lansing, MI 48910-3495
Phone (517) 975-9830

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
I20100503000764 MI Practitioner - Physician Assistant 7618005299 Reassigns benefits to 1 organization

National Provider Directory

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

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": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412380800000",
    "number": "1861639502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 S PENNSYLVANIA AVE",
            "address_2": "SUITE 105",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489103495",
            "telephone_number": "517-975-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 S PENNSYLVANIA AVE",
            "address_2": "SUITE 105",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489103495",
            "telephone_number": "517-975-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASS",
        "first_name": "PAULA",
        "middle_name": "JEAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2014-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601002093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.