Individual provider Active NPI

Madison Nicole Siegrist, PA

  • Medical Physician Assistant
  • Flat Rock, MI
National Provider Identifier
1881457216
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601012279 Issued in MI
Practice address
26342 Gibraltar Rd
Flat Rock, MI 48134-1522
Phone
(734) 346-0151
NPI assigned
Jan 30, 2024
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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 5601012279 MI Primary

Addresses

Primary practice location

26342 Gibraltar Rd
Flat Rock, MI 48134-1522

Mailing address

15485 Oakleigh
Southgate, MI 48195-8533
Phone (734) 775-4408

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
I20240405003673 MI Practitioner - Physician Assistant 6800234063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Lung and Sleep Association PCGroup PAC ID 5799194981, 5 clinicians

Practice addresses (Care Compare)

26342 Gibraltar Rd
Flat Rock, MI 48134-1522
Phone (734) 346-0151

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Lungs & Critical Care Specialists PLLC CurrentSince Oct 5, 2025 Accepting new patients

Locations

26342 Gibraltar Rd
Flat Rock, MI 48134
Phone (313) 914-4590

Interoperability endpoints

  • Direct secure messaging: msiergrist1871667@epic00.shdirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1881457216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15485 OAKLEIGH",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481958533",
            "telephone_number": "734-775-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26342 GIBRALTAR RD",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481341522",
            "telephone_number": "734-346-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGRIST",
        "first_name": "MADISON",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601012279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flat Rock, MI

Sources for this page

Verify at the official NPI Registry.