KELLY J GINGRAS (NPI# 1972551935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972551935 |
| Entity Type | Individual |
| Full Name | KELLY J GINGRAS |
| Credential | PA |
| Practice Address |
18101 Oakwood Blvd Dearborn MI 48123 |
| Mailing Address |
18101 Oakwood Blvd Dearborn MI 48124-4089 |
| Practice Telephone | 3139825440 |
| Mailing Telephone | 3139825440 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2013-06-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601005311 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PALMETTO MEDICARE | PA25091 | 01 | |
| TAX ID # | 311098079 | 01 | |
| SUBMITTER NO. | 353077 | 01 |
| Street Address |
18101 OAKWOOD BLVD |
| City | DEARBORN |
| State | MI |
| Zip Code | 48123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578568036 | Professional Emergency Care, P.C. | Internal Medicine | 18101 Oakwood Blvd, Emergency Medicine Department, Dearborn, MI 48124-4089 | 2005-06-20 |
| 1932706033 | Janette Torrico-woo | Registered Nurse | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2020-10-02 |
| 1528665577 | Nadia Farhat | General Acute Care Hospital | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2020-10-02 |
| 1992302053 | Sara Marquardt | Registered Nurse | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2020-10-02 |
| 1790382869 | Jennifer Anne Rotter | Registered Nurse | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2020-10-02 |
| 1184230054 | Ashley Stoeckle | Clinical Nurse Specialist | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2020-09-16 |
| 1841802584 | Lamise Mohana | Registered Nurse | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2020-08-22 |
| 1629687058 | Samantha Ross | Registered Nurse | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2020-07-31 |
| 1114535499 | Lauren E Krall | Registered Nurse | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2020-07-22 |
| 1649888959 | Layale Makki | Registered Nurse | 18101 Oakwood Blvd, Dearborn, MI 48124-4089 | 2020-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215090840 | Michael S. Malian | Surgery | 18101 Oakwood Boulevard, Beaumont Hospital, Dearborn Trauma Svcs, Dearborn, MI 48123 | 2006-12-18 |
| 1184717738 | Spinal Therapeutics, Inc | Family Medicine | 22731 Newman Suite 102, Dearborn, MI 48123 | 2006-10-02 |
| 1386676195 | Christine Giska Westphal | Nurse Practitioner | 18101 Oakwood, Suite 126, Dearborn, MI 48123-2500 | 2006-07-06 |
| 1912179995 | Sara Ann Troyer | Pediatrics | 4700 Schaefer Rd, Dearborn, MI 48123-3698 | 2008-03-30 |
| 1306040639 | Lee Ann Thorp | Pediatrics | 4700 Schaefer Rd, Dearborn, MI 48123-3698 | 2007-06-12 |
| 1689680589 | Gary Lee Davis | Emergency Medicine | 4700 Schaefer Rd, Dearborn, MI 48123-3698 | 2006-07-31 |
| 1003889205 | Steven Allan Acker | Orthopaedic Surgery | 4700 Schaefer Rd, Dearborn, MI 48123-3698 | 2006-02-08 |
| 1235100033 | Robert P. Rubin | Podiatrist | 4700 Schaefer Rd, Dearborn, MI 48123-3698 | 2006-01-30 |
| 1467604801 | Sammit K Sabharwal | Internal Medicine | 18000 Oakwood Blvd, Dearborn, MI 48123-4089 | 2008-10-16 |
| 1902920028 | Krisseda S Solomon | Personal Emergency Response Attendant | 18101 Oakwood Blvd, Emergency Dept, Dearborn, MI 48123-4089 | 2007-03-16 |
| Find all providers in zip 48123 | ||||
| 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 |
|---|---|---|---|---|
| 1326664194 | Ibrahim Humaisan | Physician Assistant | 1769 Walnut St, Dearborn, MI 48124-4025 | 2020-06-17 |
| 1518514900 | Afrah Saadi | Physician Assistant | 3375 Hollywood St, Dearborn, MI 48124-4360 | 2019-08-21 |
| 1801352067 | Stacey Marie Stewart | Physician Assistant | 3021 Grindley Park St, Dearborn, MI 48124-4522 | 2019-02-13 |
| 1407206105 | Ayah Jaafar | Physician Assistant | 15120 Prospect St, Dearborn, MI 48126-2922 | 2016-06-14 |
| 1174970693 | Jaber Mawiri | Physician Assistant | 5402 Bingham St, Dearborn, MI 48126-3306 | 2016-05-16 |
| 1699134080 | Mohamad Nehme | Physician Assistant | 5200 Orchard Ave, Dearborn, MI 48126-4620 | 2016-02-15 |
| 1578948220 | Eaman Alhaider | Physician Assistant | 3053 Lindenwood Dr, Dearborn, MI 48120-1311 | 2015-07-23 |
| 1922384064 | Cynthia Kler Rockwell | Physician Assistant | 330 Town Center Dr, Dearborn, MI 48126-2738 | 2011-11-02 |
| 1083902217 | Lena Sarsam | Physician Assistant | 10306 Dix Ave., Dearborn, MI 48120 | 2011-07-21 |
| 1356656706 | Lisa Reuter | Physician Assistant | 2040 Monroe St Ste 207, Dearborn, MI 48124-2950 | 2010-08-10 |
| Find all providers in DEARBORN | ||||
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| 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.