Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Elissa Mary Ridgeway, PAC

Individual provider Physician Assistant · NPI 1235354028

Mrs. Elissa Mary Ridgeway, PAC is a Physician Assistant in Detroit, Michigan. Qualified in 2003, 23 years ago. Practices with Henry Ford Health System, a 2,540-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
23
Licensed in
MI
In the registry since
2007
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

2799 W Grand Blvd Dept OF Surgery
Detroit, MI 48202-2608
Phone: (313) 916-3037
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601004581 (MI)

Record details

NPI number1235354028
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedApril 16, 2007
Last updated in NPPESFebruary 19, 2021
Certification dateFebruary 19, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Henry Ford Health System — 2540 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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