Active NPI
Lauren Guastella
- Physician Assistant
- West Bloomfield, MI
National Provider Identifier
1902286198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601007343
- Practice address
- 6777 W Maple Rd
West Bloomfield, MI 48322-3013 - Phone
- (313) 916-3618
- NPI assigned
- Jun 3, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601007343 | MI | Primary |
Addresses
Primary practice location
6777 W Maple Rd
West Bloomfield, MI 48322-3013
Mailing address
13771 Wellington Dr
Sterling Heights, MI 48313-3479
Phone (586) 482-0178
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601007343 | MI | MD | Physician Assistant |
Interoperability endpoints
- lbruss310363@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520985600000",
"number": "1902286198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13771 WELLINGTON DR",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483133479",
"telephone_number": "586-482-0178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6777 W MAPLE RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483223013",
"telephone_number": "313-916-3618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUASTELLA",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-03",
"last_updated": "2018-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601007343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.