Renee Elizabeth Barrett, M.D.
Individual provider Active NPI Pediatrics Physician · Rochester, MI
NPI 1063775484 · NPPES record last updated Sep 26, 2023
Key facts
- NPI
- 1063775484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 4301510167 (MI)
- Practice address
- 1101 W University Dr FL 2
Rochester, MI 48307-1863 - Phone
- (248) 652-5331
- Fax
- (248) 652-5748
- NPI assigned
- Jun 20, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231019003026 | MI | Practitioner - Pediatric Medicine | 0941516827 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054368 | CT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health St. John Hospital | Current |
Accepting new patients | |
| Henry Ford Health St. John Hospital | Pediatrics | Current |
Accepting new patients |
| Henry Ford Health St. John Hospital | Current | Accepting new patients | |
| Pathology Specialists of Southeast Michigan PC | Current | Accepting new patients |
Locations
22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248
1101 W University Dr
Fl 2
Rochester, MI 48307
Phone (248) 652-5331
1101 W University Dr
Rochester Hls, MI 48307
Phone (248) 601-4805
28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944
Interoperability endpoints
- rbarrett1116408@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 054368 | CT | |
| Pediatrics Physician | 208000000X | 4301510167 | MI | Yes |
Addresses
Primary practice location
1101 W University Dr FL 2
Rochester, MI 48307-1863
Mailing address
20 York St
Dept of Neonatal-Perinatal Medicine
New Haven, CT 06510-3220
Phone (313) 598-4971
Other names
- Renee Elizabeth Mobley
Other providers in Rochester, MI
- Shabana Nasheen Banfill
- Michael Banoub
- Barefootsouls-Com Inc
- Rebecca Barnswell
- Frank Anthony Barrack
- Samantha Nicole Barrow
- Bartol Biocic M.D. PC
- Mykeya Bartow
- David Bauer
- Joshua Beausoleil
All providers in Rochester, MI · Pediatrics Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.