DEODGE MONIQUE HILL (NPI# 1174560106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174560106 |
| Entity Type | Individual |
| Full Name | DEODGE MONIQUE HILL |
| Credential | PAC |
| Practice Address |
6071 W Outer Dr Detroit MI 48235-2624 |
| Mailing Address |
46036 Michigan Ave # 318 Canton MI 48188-2304 |
| Practice Telephone | 3139663300 |
| Practice Fax Number | 8107658169 |
| Mailing Telephone | 7343459023 |
| Mailing Fax Number | 7343285944 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | NCCPA CERTIFICATE NUMBER | 1063098 | 01 |
| Street Address |
6071 W OUTER DR |
| City | DETROIT |
| State | MI |
| Zip Code | 48235-2624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205836806 | Select Specialty Hospital - Northwest Detroit Inc | Long Term Care Hospital | 6071 W Outer Dr, 7th Floor, Detroit, MI 48235-2624 | 2005-07-26 |
| 1356965198 | Anielle Ball | Registered Nurse | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-06-07 |
| 1427672708 | Nitesh Kumar Byrappa | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-06-03 |
| 1992327969 | Chandima Jinani Herath Mudiyanselage | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235 | 2020-05-13 |
| 1790307783 | Patrick Riedy | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-05-12 |
| 1518589878 | Nnadozie Okoroafor | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-05-09 |
| 1720609803 | Charmayne Gail Cooley | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-30 |
| 1841811890 | Noren Din | Internal Medicine | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-30 |
| 1962023069 | Haseeb Khan | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-29 |
| 1285255570 | Edward Park | Student in an Organized Health Care Education/Training Program | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2020-04-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
| 1629690565 | Faseeha Arshad Gondal | Student in an Organized Health Care Education/Training Program | Detroit Medical Center Sinai Grace Hospital, 6071 Outer Dr W. Detroit, Mi 48235, United States, Detroit, MI 48235 | 2020-05-14 |
| 1902428832 | Muhanad Abou Touk | Student in an Organized Health Care Education/Training Program | Dmc - Sinai Grace Hospital, Department of Internal Medi, 6071, W. Outer Drive, Detroit, MI 48235 | 2020-05-14 |
| 1780206730 | Ahmad Mismar | Student in an Organized Health Care Education/Training Program | Detroit Medical Center - Sinai Grace Hospital, Departme, 6071 West Outer Drive, Detroit, MI 48235 | 2020-05-13 |
| 1023630589 | Joao Paulo Fontana Bragagnollo | Student in an Organized Health Care Education/Training Program | 6071 W Outer Drive-sinai Grace Hospital, Department of Medicine 4th Floor M-406, Detroit, MI 48235 | 2020-05-07 |
| 1881216216 | Mohammad Awad Jaber | Student in an Organized Health Care Education/Training Program | 6071 W. Outer Drive, Dmc Sinai-grace Hospital, Detroit, MI 48235 | 2020-05-07 |
| 1366064818 | Syeda Busmah Owais | Student in an Organized Health Care Education/Training Program | 6071 Outer Drive, Sinai Grace Hospital, Department of I, Detroit, MI 48235 | 2020-05-07 |
| 1184245680 | Sushmitha Nanja Reddy | Student in an Organized Health Care Education/Training Program | Detroit Medcen Sinai Grace Hospital Dpt of Internal Med, 6071 W Outer Drive, Detroit, MI 48235 | 2020-05-06 |
| 1972164796 | Jack Phillip Tomen | Student in an Organized Health Care Education/Training Program | Sinai - Grace Hospital, 6071 Outer Drive W, Department of Medicine - 4 Main, Detroit, MI 48235 | 2019-06-24 |
| 1346809464 | Anusha Bapatla | Student in an Organized Health Care Education/Training Program | 4 Main, 6071 West Outer Drive, Sinai-grace Hospital, Department of Internal Medicine, Detroit, MI 48235 | 2019-06-12 |
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| 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 |
|---|---|---|---|---|
| 1619583994 | Isabella Lapuz Dela Cruz | Physician Assistant | 18463 Livernois Ave, Detroit, MI 48221-2254 | 2020-09-22 |
| 1932750684 | Patrick D Wharton | Physician Assistant | 5053 Commonwealth St # 1s, Detroit, MI 48208-2039 | 2019-09-24 |
| 1942869300 | Laura Dorothy Konsitzke | Physician Assistant | 22201 Moross Rd Ste 380, Detroit, MI 48236-2176 | 2019-06-10 |
| 1619419553 | Erica Ellen Schweitzer | Physician Assistant | 4701 Saint Antoine St Ste E-510, Detroit, MI 48201-1428 | 2016-11-09 |
| 1992167027 | Heather Michelle Sutton | Physician Assistant | 3901 Beaubien Drive, Detroit, MI 48201 | 2016-03-28 |
| 1659769107 | Zhi Li | Physician Assistant | 22201 Moross Rd Ste 370, Detroit, MI 48236 | 2015-01-07 |
| 1619371564 | Charlene Sharon Staff | Physician Assistant | 17701 Warwick St, Detroit, MI 48219-4210 | 2014-10-21 |
| 1245646025 | Sara Gibrael | Physician Assistant | 259 Mack Ave # 2590, Detroit, MI 48201-2427 | 2014-07-01 |
| 1497076434 | Mary Beth Morse | Physician Assistant | 4201 St. Antoine - Uhc 5d #226, University Pediatricians, Detroit, MI 48201-2153 | 2010-06-14 |
| 1265550487 | Claudine Lilla | Physician Assistant | 6071 W Outer Dr Dept Of, Detroit, MI 48235-2624 | 2007-03-26 |
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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.