GREAT LAKES SURGICAL ASSISTANTS, PLLC
NPI 1558653303
Physician Assistant - Surgical in Troy, MI

Q: What is Great Lakes Surgical Assistants, PLLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Active since May 12, 2011

4550 INVESTMENT DR STE 100, TROY, MI 48098(248) 265-4600 Get Directions Write a Review

NPPES record last updated: July 21, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Great Lakes Surgical Assistants, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT LAKES SURGICAL ASSISTANTS, PLLC (NPI 1558653303) is a healthcare organization registered as a surgical in Troy, Michigan and active in the NPI registry since May 2011. The organization lists Brandon E Mackenzie, Owner, Pa-c, as its authorized official.

NPPES Registry Identity

NPI1558653303

Entity TypeOrganization

Primary Taxonomy363AS0400X

Legal Business NameGREAT LAKES SURGICAL ASSISTANTS, PLLC

Location Address4550 INVESTMENT DR STE 100Troy, MI 48098-6334

Mailing Address47120 Land StChesterfield, MI 48047-5142 · (586) 246-5125

Phone(248) 265-4600

Organization SubpartNo

Authorized OfficialBrandon E MackenzieOwner, Pa-c · (586) 246-5125

Enumeration DateMay 12, 2011

Last NPPES UpdateJuly 21, 2011

✔ NPI 1558653303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in MI · D5298K

4550 INVESTMENT DR STE 100, Troy, MI 48098

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Other Identifiers 2

Other0N33470042MI · Medicare Id-type Unspecified

Medicare UPINP78997MI

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. AARON ANDREW GLAESER M.D.

Anesthesiology

4550 INVESTMENT DR STE 100
TROY, MI 48098

Oakland County (248) 265-4611

REM ANESTHESIA PROFESSIONALS PLLC

Anesthesiology

4550 INVESTMENT DR STE 100
TROY, MI 48098

Oakland County (248) 265-4600

CAROL C RICHARDSON CRNA

Nurse Anesthetist, Certified Registered

4550 INVESTMENT DR STE 100
TROY, MI 48098

Oakland County (248) 265-4600

THERESA M DELPUP-SMITH

Nurse Anesthetist, Certified Registered

4550 INVESTMENT DR STE 100
TROY, MI 48098

Oakland County (248) 265-4600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Great Lakes Surgical Assistants, PLLC's NPI number?

The NPI number for Great Lakes Surgical Assistants, PLLC is 1558653303. It was assigned to this organization in the NPPES registry on May 12, 2011.

Where is Great Lakes Surgical Assistants, PLLC located?

Great Lakes Surgical Assistants, PLLC is located at 4550 Investment Dr Ste 100, Troy, MI 48098. The listed phone number is (248) 265-4600.

What is Great Lakes Surgical Assistants, PLLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Great Lakes Surgical Assistants, PLLC was last updated on July 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.