Individual Healthcare Provider
Eleanor Rachael Wiedeman, PA-C
Provider's NPPES record last updated: April 22, 2026
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1053067181
- Primary Specialty
- Physician Assistant — Medical
- Practice Location
- Southfield, Michigan
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 21, 2026, 8:46 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Physician Assistant
Medical
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363AM0700X
Provider-Reported License Information
- Physician Assistant (Michigan)
- 5601011030TMP22
Practice Locations
Practice Location
26025 Lahser Rd Fl 2
Southfield, Michigan 48033-2606
Phone: (248) 663-1900
Additional Practice Location
24255 W 13 Mile Rd Ste 100
Bingham Farms, Michigan 48025-4345
Phone: (248) 988-8085
Fax: (844) 598-9635
Additional Practice Location
26750 Providence Pkwy Ste 220
Novi, Michigan 48374-1212
Phone: (248) 596-0412
Fax: (833) 471-5849
Additional Practice Location
30575 Woodward Ave
Royal Oak, Michigan 48073-0980
Phone: (248) 280-8550
Fax: (844) 266-0093
Additional Practice Location
1350 Kirts Blvd Ste 160
Troy, Michigan 48084-4852
Phone: (248) 244-9426
Fax: (844) 607-0511
Additional Practice Location
4967 Crooks Rd Ste 100
Troy, Michigan 48098-5812
Phone: (248) 846-8060
Fax: (833) 303-1612
Additional Practice Location
33200 W 14 Mile Rd Ste 220
West Bloomfield, Michigan 48322-3586
Phone: (248) 855-7400
Fax: (844) 598-9634
Additional Practice Location
17877 W 14 Mile Rd
Beverly Hills, Michigan 48025-3127
Phone: (248) 644-3920
Fax: (844) 598-9632
Additional Practice Location
45816 Schoenherr Rd
Shelby Twp, Michigan 48315-6028
Phone: (586) 842-2400
Fax: (833) 561-1976
Record Information
- Enumeration Date
- February 28, 2022
- Provider's NPPES Record Last Updated
- April 22, 2026
- Certification Date
- April 22, 2026
- NPISignal NPPES Dataset
- August 2026
See Something Wrong?
Incorrect provider information
Everything on this page comes directly from the NPPES data CMS publishes. NPISignal cannot edit a provider's record — only the provider or organization can, directly through NPPES.
Update a record through NPPESSomething wrong with this page?
If NPISignal is displaying this data incorrectly — a formatting error, a broken link, a mismatch with the source file — let us know.
Report a display issue