Margo Ahlstrom
Individual provider Active NPI Physician Assistant · Shelby TWP, MI
NPI 1992301949 · NPPES record last updated Jan 9, 2022
Key facts
- NPI
- 1992301949
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 53375 Whitby Way
Shelby TWP, MI 48316-2751 - Phone
- (586) 907-8139
- NPI assigned
- Dec 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Rockford Psychiatric Medical Services SC
Practice addresses (Care Compare)
1202 W Monroe St
FL 1
Chicago, IL 60607-2509
Phone (630) 517-2934
1639 N Alpine Rd
Suite 260
Rockford, IL 61107-1481
Phone (815) 395-1500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250625002213 | IL | Practitioner - Physician Assistant | 2961896154 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anxiety Wellness Program | Past |
Accepting new patients |
Interoperability endpoints
- margo.ahlstrom.1@25899.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
53375 Whitby Way
Shelby TWP, MI 48316-2751
Mailing address
53375 Whitby Way
Shelby TWP, MI 48316-2751
Phone (586) 907-8139
Other providers in Shelby TWP, MI
- Adam Home Care Service Agency
- Advancedpleasantdental
- Lusilda Agolli
- Jerome James Agrusa
- Vanessa Marie Aguirre
- Fadi Raheem Al-Qas Hanna
- All-Pro Medical Supply, Inc.
- Frank Almaflahi
- Michelle J Ament
- Richard E Amenta
All providers in Shelby TWP, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.