Ellen Marie Stair, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601010295 Issued in MI

Practice address

G4007 W Court St Ste B
Flint, MI 48532-3560

Phone

(810) 399-9931

NPI assigned

Jan 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ellen Marie Sage Former name

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Head and Neck Surgery PCGroup PAC ID 5597122978, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Premier Head and Neck Surgery PC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Flint, MI
  • NPI 1578253167
  Medicare reassignment Care Compare group
• Fenton Medical Center

  • Family Medicine Physician
  • Fenton, MI
  • NPI 1134165632
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1902494909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G4007 W COURT ST STE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323560",
            "telephone_number": "810-399-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G4007 W COURT ST STE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323560",
            "telephone_number": "810-399-9931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 N Adelaide St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MI",
            "postal_code": "484302670",
            "country_code": "US",
            "telephone_number": "810-629-2245",
            "fax_number": "810-629-6535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAIR",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2025-02-01",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "SAGE",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Staff Unlimited, Inc.
• Michael Thomas Stafford II
• Natosha Stafford
• Tiffany M Stafford, FNP-C
• Stacy Stahl, MOT, OTR/L
• Bonnie Stallings, FNP-C
• Michell Kay Stalter
• Lindsay Morgan Stambaugh, PA-C
• Ronald Stamps
• Stance Health PA

• Physician Assistant in Flint, MI
• Providers in Flint, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.