Active NPI
Rachel Fayne, MD
- Dermatology Physician
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 036.168648
- Practice address
- 1500 E Medical Center Drive
TC 1910/SPC 5314
Ann Arbor, MI 48109-6314 - Phone
- (734) 936-4054
- Fax
- (734) 647-2540
- NPI assigned
- May 19, 2020
- Last updated
- Jul 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 036.168648 | IL | Primary |
Addresses
Primary practice location
1500 E Medical Center Drive
TC 1910/SPC 5314
Ann Arbor, MI 48109-6314
Mailing address
1500 E Medical Center Drive, SPC 5314
1910 Taubman Center
Ann Arbor, MI 48109-6314
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- University of Miami, LM Miller School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4495 Military TRL
Suite 204
Jupiter, FL 33458-4818
Phone (561) 296-1122
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 48 |
| Removal of skin lesions | 102 |
| Removal of skin cancer | 141 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 27 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.168648 | IL | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PBD&P Inc | Dermatology | Current | Accepting new patients |
Locations
4495 Military Trl
Ste 204
Jupiter, FL 33458
Phone (561) 296-1122
3401 Pga Blvd
Ste 420
Palm Beach Gardens, FL 33410
Phone (561) 471-1808
701 Northpoint Pkwy
Ste 300
West Palm Beach, FL 33407
Phone (561) 863-1000
Interoperability endpoints
- https://pbd.mmi.prod.fhir.ema-api.com/fhir/r4/
- rfayne@pbderm.emadirect.md
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Palm Beach Dermatology Inc
- Dermatopathology Physician
- West Palm Beach, FL
- NPI 1689640328
Dermatology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1043833544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 E MEDICAL CENTER DRIVE, SPC 5314",
"address_2": "1910 TAUBMAN CENTER",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481096314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E MEDICAL CENTER DRIVE",
"address_2": "TC 1910/SPC 5314",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481096314",
"telephone_number": "734-936-4054",
"fax_number": "734-647-2540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAYNE",
"first_name": "RACHEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-19",
"last_updated": "2024-07-01",
"certification_date": "2024-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IL",
"license": "036.168648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.