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

Vicki R Mendelson, PA

Individual provider Physician Assistant · NPI 1699023085

Vicki R Mendelson, PA is a Physician Assistant in Southfield, Michigan. Qualified in 2012, 14 years ago. Licensed in Michigan.

Years since qualifying
14
Licensed in
MI
In the registry since
2012
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

22454 Chatsford Circuit St
Southfield, MI 48034-6240
Phone: (248) 464-2285
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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 5601006408 (MI)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1699023085
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 16, 2012
Last updated in NPPESOctober 11, 2022
Certification dateOctober 11, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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