Individual provider Active NPI

Kassidy Miller

  • Physician Assistant
  • Mt Pleasant, MI
National Provider Identifier
1972466191
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1221 South Dr
Mt Pleasant, MI 48858-3257
Phone
(800) 671-1453
NPI assigned
Dec 4, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

1221 South Dr
Mt Pleasant, MI 48858-3257

Mailing address

31184 White Oak Dr
Chesterfield, MI 48047-4690

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
I20260224001384 MI Practitioner - Physician Assistant 7810478260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Hospital GroupGroup PAC ID 2365968351, 366 clinicians

Practice addresses (Care Compare)

1221 S Dr
Mt Pleasant, MI 48858-3257
Phone (989) 772-6700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Hospital Group CurrentSince Feb 3, 2026 Accepting new patients

Locations

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1764806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1972466191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31184 WHITE OAK DR",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480474690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 SOUTH DR",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488583257",
            "telephone_number": "800-671-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KASSIDY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-12-04",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.