Magda S. Vincens, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601004660 Issued in MI

Practice address

5323 Elliott Dr
Suite #102
Ypsilanti, MI 48197-8632

Phone

(734) 712-7285

NPI assigned

Apr 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Magda Soejarto 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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Joseph Mercy HospitalGroup PAC ID 3779489281, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• St Joseph Mercy Hospital

  • Otolaryngology Physician
  • Ypsilanti, MI
  • NPI 1659499705
  Medicare reassignment Care Compare group
• Saint Joseph Mercy Livingston Hospital

  • Emergency Medicine Physician
  • Brighton, MI
  • NPI 1285753236
  Medicare reassignment NPD
• Saint Joseph Mercy Livingston Hospital

  • General Acute Care Hospital
  • Brighton, MI
  • NPI 1093748642
  NPD
• St Joseph Mercy Hospital

  • Internal Medicine Physician
  • Ypsilanti, MI
  • NPI 1649399197

  Surgical

  NPD
• St Joseph Mercy Hospital

  • Cardiac Rehabilitation Clinic/Center
  • Ypsilanti, MI
  • NPI 1902359094
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Mercy Hospital

  dba Trinity Heath Ann Arbor Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1902868482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 ELLIOTT DR",
            "address_2": "SUITE #102",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 ELLIOTT DR",
            "address_2": "SUITE #102",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978632",
            "telephone_number": "734-712-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENS",
        "first_name": "MAGDA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601004660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAGDA",
            "last_name": "SOEJARTO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Ann Vigil, PT
• Luis Villa, PTA
• Phillip John Villanueva, PA-C
• Yessa Villarreal
• Paul M Villiard, MS, PA-C
• Vincent D. Dinick, DMD, MD, PC
• Jennifer Ann Vincent
• Kaitlyn Hillary Marie Vincent
• Sydney Rose Vinson
• Aubree H Vipond

• Surgical Physician Assistant in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Surgical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.