Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1417924499 Individual Practitioner Female Practitioner

Sandra Lodge

Physician Assistant • Troy, MI

Professional Overview & Biography Verified Profile Summary

Sandra Lodge is a registered healthcare professional specializing in Physician Assistant in Troy, MI. Practice services are available at 44201 DEQUINDRE RD under active NPI credentials.

Frequently performed procedures and clinical services include new patient outpatient office visit, detection test by immunoassay with direct visual observation for influenza virus, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

44201 Dequindre Rd

Troy, MI 480851117

Telephone 2489645000
Associated Practice Facility / Clinic
🏢 William Beaumont Hospital Facility NPI 1306825997

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Troy, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.1 Yrs
State Avg: 12.2 Yrs
Regional Practice Density
239 Specialists

Practicing in Troy, MI (7057 Statewide)

Telehealth Adoption Rate
8.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
47.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
44 44 $250.00 $146.27
87804 Detection test by immunoassay with direct visual observation for influenza virus
24 12 $61.00 $16.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
20 19 $163.00 $97.39
81003 Automated urinalysis test
14 14 $25.00 $2.44

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MI 5601003636

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Medicare
0N67850011 (MI)
Commercial Insurance / Payer ID Bcbsm
0E01007 (MI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003730268
Dr. Kristen Light , DNP, RN, AGPCNP-BC

Nurse Practitioner - Primary Care

NPI 1013435619

Doctor of Nursing Practice, Registered Nurse, AGPCNPBC

Samantha Henderson , PA-C

Physician Assistant

NPI 1013502962

Physician Assistant (Certified)

Sharon Lindow

Speech-Language Pathologist

NPI 1023431632
Nicole Trudeau-Klimek , NP

Nurse Practitioner

NPI 1023597168

Nurse Practitioner

Matthew Norman

Nurse Anesthetist, Certified Registered

NPI 1043198732

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
NPI Profile Active October 23, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location October 23, 2017

Registered at 44201 DEQUINDRE RD, TROY, MI 480851117 (Tel: 2489645000)

📍
Updated Business Mailing Address October 23, 2017

Registered at 3601 W 13 MILE RD, 400-FSC/PCS, ROYAL OAK, MI 480736712

👤
Provider Name / Credentials Updated October 23, 2017

Recorded as SANDRA LODGE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 23, 2017

Physician Assistant (License #5601003636 in MI)

NPI Profile Active November 15, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location November 15, 2007

Registered at 44201 DEQUINDRE RD, TROY, MI 480851117 (Tel: 2489645000)

📍
Updated Business Mailing Address November 15, 2007

Registered at 3601 W 13 MILE RD, 400-FSC/PCS, ROYAL OAK, MI 480736712

👤
Provider Name / Credentials Updated November 15, 2007

Recorded as SANDRA LODGE KNIGHT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 15, 2007

Physician Assistant (License #5601003636 in MI)

🟢
Initial NPI Registration & Enumeration March 08, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417924499
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 08, 2006
Last Update: October 23, 2017
Sole Proprietor: No

Mailing Address

3601 W 13 Mile Rd, 400-Fsc/pcs

Royal Oak, MI 480736712

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.