Tabetha Kassab, OT is a medicare enrolled "Physician Assistant" provider in West Bloomfield, Michigan. Her current practice location is
6777 W Maple Rd, West Bloomfield, Michigan. You can reach out to her office (for appointments etc.) via phone at
(248) 416-4140.
Tabetha Kassab is licensed to practice in Michigan (license number 5601011082) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1508444589.
Healthcare Provider's Profile
Full Name | Tabetha Kassab |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 6777 W Maple Rd, West Bloomfield, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1508444589
- Provider Enumeration Date: 03/31/2021
- Last Update Date: 04/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 9830564178
- Enrollment ID: I20230418002814
Medical Identifiers
Medical identifiers for Tabetha Kassab such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508444589 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225X00000X | Occupational Therapist | (Michigan) | Secondary |
363A00000X | Physician Assistant | 5601011082 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tabetha Kassab is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tabetha Kassab, OT 1 Ford Pl Ste 3a, Detroit, MI 48202-3450 Ph: (313) 874-4806 | Tabetha Kassab, OT 6777 W Maple Rd, West Bloomfield, MI 48322 Ph: (248) 416-4140 |
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