| Deangelo Webster, PA-C | |
|
375 Eureka Rd Ste B, Wyandotte, MI 48192 | |
| (734) 225-9300 | |
| Not Available |
| Full Name | Deangelo Webster |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 28 Years |
| Location | 375 Eureka Rd Ste B, Wyandotte, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598787079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 5601002997 (Michigan) | Secondary |
| 363AS0400X | Physician Assistant - Surgical | 5601002997 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Trinity Health Ann Arbor Hospital | Ypsilanti, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Iha Health Services Corporation | 2466351440 | 1149 |
| Nextcare Michigan Providers Pllc | 5395157218 | 16 |
| Entity Name | Iha Health Services Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457408965 PECOS PAC ID: 2466351440 Enrollment ID: O20040108000355 |
| Entity Name | Seton Health Corporation of Southeastern Michigan |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598177065 PECOS PAC ID: 2567689540 Enrollment ID: O20140814002590 |
| Entity Name | Nextcare Michigan Providers PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972106938 PECOS PAC ID: 5395157218 Enrollment ID: O20201218000348 |
| Mailing Address | Practice Location Address |
|---|---|
| Deangelo Webster, PA-C 17197 N Laurel Park Dr Ste 107, Livonia, MI 48152-7910 Ph: (734) 338-8300 | Deangelo Webster, PA-C 375 Eureka Rd Ste B, Wyandotte, MI 48192 Ph: (734) 225-9300 |
Marissa Gabrielle Romo, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-6000 |
Dr. Ibrahim Hussein Dabaja, PA-C, PH.D. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1768 Ford Ave, Wyandotte, MI 48192 Phone: 313-377-5758 Fax: 734-574-6060 |
Alyssa Christie, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 735-246-6000 |
Kayla Gacioch, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2300 Biddle Ave Ste 100, Wyandotte, MI 48192 Phone: 734-246-5705 |
Kaitlin Elizabeth Flaherty, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-6000 |
Vanessa Varma, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2025 Ford Ave, Ste. 100, Wyandotte, MI 48192 Phone: 586-612-3556 |
Alexis Alicia Hernandez, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2070 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-6000 |