| Primary Care Associates Group PC | |
|
22631 Greater Mack Ave Saint Clair Shores MI 48080-2055 | |
| (586) 800-0086 | |
| (586) 800-0087 |
| Full Name | Primary Care Associates Group PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 22631 Greater Mack Ave, Saint Clair Shores, Michigan |
| Authorized Official Name and Position | Diana El Masri (CREDENTIALOR) |
| Authorized Official Contact | 2482150048 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Associates Group PC 22631 Greater Mack Ave Saint Clair Shores MI 48080-2055 Ph: (586) 800-0086 | Primary Care Associates Group PC 22631 Greater Mack Ave Saint Clair Shores MI 48080-2055 Ph: (586) 800-0086 |
| NPI Number | 1235972860 |
|---|---|
| Provider Enumeration Date | 06/12/2024 |
| Last Update Date | 06/12/2024 |
| Certification Date | 06/12/2024 |
| Medicare PECOS PAC ID | 4981149630 |
|---|---|
| Medicare Enrollment ID | O20240717003134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235972860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Amine Amine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861812828 PECOS PAC ID: 6305118175 Enrollment ID: I20170815001598 |
| Provider Name | Victoria L Stark |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902371735 PECOS PAC ID: 8628498003 Enrollment ID: I20201023002513 |
| Provider Name | Kerrily Quay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043831910 PECOS PAC ID: 3072918481 Enrollment ID: I20210824001317 |
| Provider Name | Meghan Pasquali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609587682 PECOS PAC ID: 6901277318 Enrollment ID: I20230123002143 |
| Provider Name | Elizabeth Henson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467164764 PECOS PAC ID: 4385017243 Enrollment ID: I20230224000952 |
| Provider Name | Scott Jenner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063361343 PECOS PAC ID: 8729562327 Enrollment ID: I20260321000291 |
Bi-county Physicinas Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 21600 Harper Ave Ste 100, Saint Clair Shores, MI 48080 Phone: 586-498-4800 Fax: 586-800-1002 |
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