Individual provider Active NPI

Michael Swabash, PA-C

  • Physician Assistant
  • Lapeer, MI
National Provider Identifier
1922630763
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010196 Issued in MI
Practice address
3273 Davison Rd Ste 5
Lapeer, MI 48446-4306
Phone
(810) 245-7766
Fax
(810) 245-6216
NPI assigned
Feb 10, 2020
Last updated
Jan 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601010196 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3273 Davison Rd Ste 5
Lapeer, MI 48446-4306

Mailing address

PO Box 734241
Chicago, IL 60673-4241

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
I20201124002078 MI Practitioner - Physician Assistant 1355752395 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Central Michigan College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

100 W Argyle St
Suite 2
Sandusky, MI 48471-1097
Phone (810) 245-7766

1080 S Van Dyke Rd
Suite 400
Bad Axe, MI 48413-9635
Phone (810) 245-7766

1800 W Caro Rd
Suite III
Caro, MI 48723-8209
Phone (810) 245-7766

3273 Davison Rd
Suite 5
Lapeer, MI 48446-4306
Phone (810) 245-7766

37605 Pembroke Ave
Livonia, MI 48152-1050
Phone (734) 591-7931

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601010196MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Audrey Bruell, M.D. P.C. Current Accepting new patients

Locations

37605 Pembroke Ave
Livonia, MI 48152
Phone (734) 591-7931

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1922630763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734241",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606734241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3273 DAVISON RD STE 5",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484464306",
            "telephone_number": "810-245-7766",
            "fax_number": "810-245-6216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWABASH",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-10",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010196",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

Verify at the official NPI Registry.