MS. CHANNING COREANE ODAY (PAC) – Surgical Physician Assistant, NPI 1194762161
Surgical Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for MS. CHANNING COREANE ODAY (PAC)
22101 Moross Rd
Detroit, MI 482362148
Phone: (313) 343-4000
Type: Location
29992 Northwestern Hwy
Farmington Hills, MI 483343292
Phone: (248) 735-8272
Type: Location
5241 DOHERTY DR
WEST BLOOMFIELD, MI 483233413
Phone: (248) 342-0074
Type: Mailing
Henry Ford West Bloomfield Hospital, 6777, West Maple Road, West Bloomfield Township, Oakland County, Michigan, 48322, United States
WEST BLOOMFIELD, MI 483223013
Phone: (248) 325-1000
Type: Location
6174, Westbrooke Drive, Westbrooke Condos, West Bloomfield Township, Oakland County, Michigan, 48322, United States
WEST BLOOMFIELD, MI 483223227
Phone: (248) 342-0074
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-03-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070328000102 | I | Physician Assistant | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48236)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Gastroenterology, Internal Medicine | PA | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Clinical Social Worker | MI | |
| - | MI | |
| Physician Assistant | MI | |
| Qualified Audiologist | MI | |
| O P H T H A L M O L O G Y | MI | |
| - | MI | |
| - | MI |
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