AMANDA M BASIL-PORTER (NPI# 1528441854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528441854 |
| Entity Type | Individual |
| Full Name | AMANDA M BASIL-PORTER |
| Other Name | AMANDA M AJINE-BASIL |
| Credential | PA-C |
| Practice Address |
25631 Little Mack Ave Ste 205 Saint Clair Shores MI 48081-2108 |
| Mailing Address |
320 E North Ave Ste 261 Pittsburgh PA 15212-4756 |
| Practice Telephone | 5864432380 |
| Practice Fax Number | 5864432935 |
| Mailing Telephone | 4123593901 |
| Mailing Fax Number | 4123594514 |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2020-04-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601009765 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | MA057154 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
25631 LITTLE MACK AVE STE 205 |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48081-2108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235251042 | Robbie H Taha | Internal Medicine | 25631 Little Mack Ave Ste 205, Saint Clair Shores, MI 48081-2108 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750865416 | Saint Clair Family Pharmacy LLC | Pharmacy | 28001 Harper Ave., Saint Clair Shores, MI 48081 | 2018-09-19 |
| 1669995783 | Terra Laquay Ginther | Social Worker | 28800 Harper Ave Ste A, Saint Clair Shores, MI 48081 | 2017-07-20 |
| 1245676998 | Julia Hanson | Social Worker | 27941 Harper Ave., Suite 105, St. Clair Shores, MI 48081 | 2013-05-21 |
| 1760731301 | Life Transition Service | Community/Behavioral Health | 21031 Sunnydale, St. Clair Shore, MI 48081 | 2012-08-29 |
| 1477868792 | William Burr Wood | Pharmacist | 21000 Twelve Milerd., St Clair Shores, MI 48081 | 2010-08-11 |
| 1508094350 | Dominic Anthony Garrisi | Anesthesiology | 21018 Bon Brae, St. Clair Shores, MI 48081 | 2009-06-30 |
| 1992947022 | Karen Ostrowski-thomas | Occupational Therapist | 22442 Bayview, St. Clair Shores, MI 48081 | 2009-04-06 |
| 1891979787 | Chirag Rachhadia | Physical Therapist | 29150 Harper Avenue, St. Clair Shores, MI 48081 | 2007-12-27 |
| 1598955114 | Donna Warner Manczak | Psychologist | 21400 E Eleven Mil Rd, St Clair Shores, MI 48081 | 2007-07-30 |
| 1467652347 | Sumit Narayanprasad Fogla | Family Medicine | 21400 E Eleven Mile Road, St. Clair Shores, MI 48081 | 2007-07-19 |
| Find all providers in zip 48081 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265090799 | Eva Abiragi | Physician Assistant | 25631 Little Mack Ave Ste 104, Saint Clair Shores, MI 48081-2100 | 2019-05-30 |
| 1912564576 | Kelsey Alexandra Kusch | Physician Assistant | 21213 Francis St, Saint Clair Shores, MI 48082-1587 | 2019-05-20 |
| 1306250634 | Jacquelyn Lauren Merecki | Physician Assistant | 22531 Oconnor St, Saint Clair Shores, MI 48080-2148 | 2014-06-14 |
| 1386996858 | Nicole M Vichunas | Physician Assistant | 25123 Culver St, Saint Clair Shores, MI 48081-2121 | 2012-10-09 |
| 1083915052 | Andrea Williams | Physician Assistant | 22837 Avalon St, Saint Clair Shores, MI 48080-2468 | 2010-11-08 |
| 1609185669 | Andrea Lynn Taft | Physician Assistant | 221 Villa Ln, Saint Clair Shores, MI 48080-2737 | 2010-09-24 |
| 1790752723 | Teresa Ostaszewski | Physician Assistant | 25311 Little Mack Ave Ste B, Saint Clair Shores, MI 48081-3301 | 2006-03-08 |
| 1508480021 | Kelsey Marie Owens | Physician Assistant | 24400 Greater Mack Ave, Saint Clair Shores, MI 48080-1340 | 2020-06-01 |
| 1578113171 | Daric Alexander Mueller | Physician Assistant | 29200 Harper Ave, Saint Clair Shores, MI 48081-1274 | 2019-09-16 |
| 1730646696 | Maren Bahra | Physician Assistant | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-3207 | 2019-02-27 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48081 |
Please comment or provide details below to improve the information on AMANDA M BASIL-PORTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.