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DOMONIQUE BAZILE
NPI 1659140655
Physician Assistant in Detroit, MI

Active since January 01, 2024PECOS Enrolled
18463 LIVERNOIS AVE, DETROIT, MI 48221(313) 369-1500(248) 336-9137 Get Directions Write a Review

NPPES record last updated: September 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 17, 2025, Aug 10, 2025, Jan 1, 2024 (3 updates tracked since 2024).

About Domonique Bazile NPPES

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

DOMONIQUE BAZILE (NPI 1659140655) is an individual physician assistant in Detroit, Michigan and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1659140655
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameDOMONIQUE BAZILE
Location Address18463 LIVERNOIS AVEDetroit, MI 48221-2254
Mailing Address18000 W 9 Mile Rd Ste 200Southfield, MI 48075-4020 · (248) 336-4000
Phone(313) 369-1500
Fax(248) 336-9137
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJanuary 1, 2024
Last NPPES UpdateSeptember 17, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2025
✔ NPI 1659140655 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
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.
18463 LIVERNOIS AVE, Detroit, MI 48221
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Domonique Bazile is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335648963
PECOS Enrollment IDI20250819004538
Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48221 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

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

SYLVIA KRISTINE HOLLOWELL MD
Family Medicine
18463 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (313) 369-1500
KATRINA MARIE COLLINS PA-C
Physician Assistant
18463 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (248) 336-4000
MARIAM M SAREINI PA-C
Physician Assistant
18463 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (313) 861-4400
CHRISTINA MARIA GEORGE DNP, FNP-BC
Nurse Practitioner (Family)
18463 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (313) 369-1500
MS. ADRIAN DANIELLE GRIFFIN FNP
Nurse Practitioner
18463 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (313) 369-1500
EXCLUSIVE PHYSICIANS PLLC
Non-Pharmacy Dispensing Site
18463 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (313) 861-4400
DAVID K WASH MD
Family Medicine
18463 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (313) 369-1500
SAMRA HAQUE
Physician Assistant
18463 LIVERNOIS AVE
DETROIT, MI 48221
Wayne County (313) 369-1500

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 Domonique Bazile's NPI number?

The NPI number for Domonique Bazile is 1659140655. It was assigned to this individual provider in the NPPES registry on January 1, 2024.

Where is Domonique Bazile located?

Domonique Bazile practices at 18463 Livernois Ave, Detroit, MI 48221. The listed phone number is (313) 369-1500.

What is Domonique Bazile's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Domonique Bazile enrolled in Medicare?

Yes. Domonique Bazile is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Domonique Bazile was last updated on September 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.