Individual provider Active NPI

Lauren Plasky

  • Physician Assistant
  • Grosse Pointe, MI
National Provider Identifier
1972379428
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
17000 Kercheval Ave Ste 215
Grosse Pointe, MI 48230-1572
Phone
(313) 882-5777
NPI assigned
Nov 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

17000 Kercheval Ave Ste 215
Grosse Pointe, MI 48230-1572

Mailing address

17000 Kercheval Ave Ste 215
Grosse Pointe, MI 48230-1572

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
I20250211000154 MI Practitioner - Physician Assistant 2668902321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Dermatology Group PCGroup PAC ID 8325338148, 5 clinicians

Practice addresses (Care Compare)

1392 S Cass Lake Rd
Waterford, MI 48328-4741
Phone (248) 338-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shauna Ryder Diggs MD PC CurrentSince Jul 28, 2024 Accepting new patients

Locations

17000 Kercheval Ave
Ste 215
Grosse Pointe Park, MI 48230
Phone (313) 822-5777

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1972379428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 KERCHEVAL AVE STE 215",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 KERCHEVAL AVE STE 215",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301572",
            "telephone_number": "313-882-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLASKY",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe, MI

Sources for this page

Verify at the official NPI Registry.