Individual provider Active NPI

Amani Tanios, PA-C

  • Medical Physician Assistant
  • Detroit, MI
National Provider Identifier
1992133144
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601006854 Issued in MI
Practice address
22201 Moross Rd
Suite 170
Detroit, MI 48236-2169
Phone
(586) 247-4300
Fax
(586) 532-6496
NPI assigned
Oct 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601006854 MI Primary

Addresses

Primary practice location

22201 Moross Rd
Suite 170
Detroit, MI 48236-2169

Mailing address

813 Mercer CT
Rochester Hills, MI 48307-3091
Phone (248) 563-6104

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
I20140110000291 MI Practitioner - Physician Assistant 5092943407 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

6777 W Maple Rd
Henry Ford West Bloomfield Med Ctr
West Bloomfield, MI 48322-3013
Phone (248) 661-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601006854MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greenfield and 9 Mile Medical Center PLLC CurrentSince Nov 19, 2014 Accepting new patients
Henry Ford Health System CurrentSince Dec 1, 2019 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Dec 1, 2019 Accepting new patients
True Health Primary Care PLLC Past Accepting new patients
Colorado Springs Nephrology Past Accepting new patients

Locations

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

20820 Greenfield Rd
Oak Park, MI 48237
Phone (248) 557-3303

Interoperability endpoints

  • Direct secure messaging: atanios548580@direct.hfhs.org

Organizations & group practices 6

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": "1382659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1992133144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 MERCER CT",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073091",
            "telephone_number": "248-563-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD",
            "address_2": "SUITE 170",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362169",
            "telephone_number": "586-247-4300",
            "fax_number": "586-532-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANIOS",
        "first_name": "AMANI",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-25",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.