Individual provider Active NPI

Margo L Gillman, PA-C

  • Physician Assistant
  • Lansing, MI
National Provider Identifier
1932479136
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007010 Issued in MI
Practice address
2909 E Grand River Ave Ste 102
Lansing, MI 48912-4335
Phone
(517) 364-8627
NPI assigned
Jan 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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 085.004113 IL
Physician Assistant 363A00000X 5601007010 MI Primary

Addresses

Primary practice location

2909 E Grand River Ave Ste 102
Lansing, MI 48912-4335

Mailing address

2909 E Grand River Ave Ste 102
Lansing, MI 48912-4335
Phone (517) 364-8627

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
I20140623001183 MI Practitioner - Physician Assistant 0143480640 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Edward W Sparrow Hospital Association 698 clinicians
Vituity - Michigan Hospitalists PC 76 clinicians

Practice addresses (Care Compare)

1200 E Michigan Ave
Suite 500
Lansing, MI 48912-1864
Phone (517) 484-4033

1200 E Michigan Ave
Suite 500
Lansing, MI 48912-1899

1215 E Michigan Ave
Lansing, MI 48912-1811
Phone (517) 364-1000

406 E Elm St
Carson City, MI 48811-9693
Phone (989) 584-3131

Hospital & facility affiliations

  • Sparrow Home Care Home health agency, Lansing, MI, CCN 237164
  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • University of Michigan Health - Sparrow Eaton Hospital, Charlotte, MI, CCN 231327

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085.004113ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital CurrentSince Dec 4, 2024 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince May 1, 2023 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince May 14, 2024 Accepting new patients
Sparrow Carson Hospital CurrentSince Dec 4, 2024 Accepting new patients
Sparrow Carson Hospital CurrentSince Dec 4, 2024 Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients
Sparrow Carson Hospital Past Accepting new patients
F G Obregon & Associates SC Past Accepting new patients
Fox Valley Physician Services SC Physician Assistant Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

102 S 3rd St
Ste 100
Carson City, MI 48811
Phone (989) 584-1308

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

1014 E Washington St
Greenville, MI 48838
Phone (616) 754-7145

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

1200 E Michigan Ave
Ste 500
Lansing, MI 48912
Phone (517) 364-5123

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1200 E Michigan Ave
Ste 530
Lansing, MI 48912
Phone (517) 364-5880

1004 E Michigan Ave
Lansing, MI 48912
Phone (517) 364-9790

1120 E Michigan Ave
Ste A
Lansing, MI 48912
Phone (517) 364-9777

2909 E Grand River Ave
Ste 102
Lansing, MI 48912
Phone (517) 364-8670

716 N Clippert St
Lansing, MI 48912
Phone (517) 253-4000

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

Organizations & group practices 31

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.

View all 31

Hospital & facility affiliations 6

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": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1932479136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 E GRAND RIVER AVE STE 102",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124335",
            "telephone_number": "517-364-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 E GRAND RIVER AVE STE 102",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124335",
            "telephone_number": "517-364-8627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLMAN",
        "first_name": "MARGO",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.004113",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.