Individual provider Active NPI

Rebecca Wyatt, DO

  • Physical Medicine & Rehabilitation Physician
  • Lansing, MI
National Provider Identifier
1053573048
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5101017592 Issued in MI
Practice address
1200 E Michigan Avenue
Ste 520
Lansing, MI 48912-1837
Phone
(517) 364-5260
Fax
(517) 364-5251
NPI assigned
Jun 30, 2008
Last updated
Jun 16, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5101017592 MI Primary

Addresses

Primary practice location

1200 E Michigan Avenue
Ste 520
Lansing, MI 48912-1837

Mailing address

804 Service Rd
A201
East Lansing, MI 48824-7015
Phone (517) 884-2976

Other identifiers 1

IdentifierTypeStateIssuer
1053573048MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120813000290 MI Practitioner - Physical Medicine and Rehabilitation 9436305117 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Michigan State University College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren FlintGroup PAC ID 8628975497, 144 clinicians

Practice addresses (Care Compare)

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2063

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101017592MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Free Bed Rehabilitation Hospital Physical Medicine & Rehabilitation CurrentSince Mar 2, 2026 Accepting new patients
McLaren Flint CurrentSince Jan 1, 2022 Accepting new patients
McLaren Northern Michigan CurrentSince May 25, 2024 Accepting new patients
McLaren Bay Region CurrentSince Feb 1, 2022 Accepting new patients
Mary Free Bed Rehabilitation Hospital CurrentSince Mar 2, 2026 Accepting new patients
McLaren Northern Michigan CurrentSince May 25, 2024 Accepting new patients
McLaren Bay Region CurrentSince Feb 1, 2022 Accepting new patients
Michigan State University Past Accepting new patients
University Rehabilitation Alliance, Inc. PastSince Feb 2, 2015 Accepting new patients
Michigan State University Past Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422

2940 Health Pkwy
Mt Pleasant, MI 48858
Phone (989) 466-2877

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1053573048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD",
            "address_2": "A201",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-2976",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVENUE",
            "address_2": "STE 520",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121837",
            "telephone_number": "517-364-5260",
            "fax_number": "517-364-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "REBECCA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101017592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053573048",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.