Individual provider Active NPI

Shehnaz Abdrabboh, PAC

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1962521781
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004693 Issued in MI
Practice address
4201 Saint Antoine St
Detroit, MI 48201-2153
Phone
(313) 745-3000
NPI assigned
Mar 29, 2007
Last updated
Dec 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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 5601004693 MI Primary
Medical Physician Assistant 363AM0700X 5601004693 MI

Addresses

Primary practice location

4201 Saint Antoine St
Detroit, MI 48201-2153

Mailing address

400 Mack Ave
Detroit, MI 48201-2136

Other practice location 1

4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266

Other practice location 2

208 N Shiawassee St
Owosso, MI 48867-2755
Phone (989) 725-2667

Other practice location 3

3990 John R St
Detroit, MI 48201-2018
Phone (313) 745-8040

Other identifiers 1

IdentifierTypeStateIssuer
12357964OtherMICAQH

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
I20110526000358 MI Practitioner - Physician Assistant 8820275910 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601004693MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group CurrentSince Dec 1, 2025 Accepting new patients
Emurgent Care Clinic PLLC CurrentSince Nov 1, 2025 Accepting new patients
University Physician Group Past Accepting new patients
Warren Urgent Care PC PastSince Oct 22, 2023 Accepting new patients
Emergency Medical Associates, PLLC Physician Assistant Past Accepting new patients
Medical Observation Services, PLLC Past Accepting new patients
University Physician Group Past Accepting new patients
Emergisystems, L. L. C. PastSince Dec 21, 2012 Accepting new patients
Southgate Urgent Care PC PastSince Oct 22, 2023 Accepting new patients

Locations

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

400 Mack Ave
Detroit, MI 48201
Phone (313) 448-9006

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

8030 N Middlebelt Rd
Westland, MI 48185
Phone (313) 406-4382

Organizations & group practices 9

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1962521781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 John R St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012013",
            "country_code": "US",
            "telephone_number": "800-527-6266",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "208 N Shiawassee St",
            "address_purpose": "LOCATION",
            "city": "Owosso",
            "state": "MI",
            "postal_code": "488672755",
            "country_code": "US",
            "telephone_number": "989-725-2667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3990 John R St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012018",
            "country_code": "US",
            "telephone_number": "313-745-8040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABDRABBOH",
        "first_name": "SHEHNAZ",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004693",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004693",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12357964",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.