Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stacey Lynn Prantera, PA-C

Individual provider Physician Assistant · NPI 1063592046

Stacey Lynn Prantera, PA-C is a Physician Assistant in Detroit, Michigan. Qualified in 2004, 22 years ago. Practices with Henry Ford Health System, a 2,540-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
22
Licensed in
MI
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone: (313) 916-0841
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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 5601004380 (MI)

Record details

NPI number1063592046
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 16, 2006
Last updated in NPPESOctober 9, 2023
Certification dateOctober 9, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Henry Ford Health System — 2540 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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