Individual provider Active NPI

Rebecca Boston, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Bloomfield Hills, MI
National Provider Identifier
1073976213
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
4301508638 Issued in MI
Practice address
60 W Big Beaver Rd Ste 100
Bloomfield Hills, MI 48304-3913
Phone
(248) 258-5100
NPI assigned
Apr 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 4301508638 MI Primary

Addresses

Primary practice location

60 W Big Beaver Rd Ste 100
Bloomfield Hills, MI 48304-3913

Mailing address

60 W Big Beaver Rd Ste 100
Bloomfield Hills, MI 48304-3913
Phone (248) 258-5100

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
I20230728000638 MI Practitioner - Plastic and Reconstructive Surgery 8022303304 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Michigan Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health HospitalsGroup PAC ID 8921904764, 161 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 391-1774

100 Michigan St Northeast
Corewell Health Grand Rapids Hospit
Grand Rapids, MI 49503-2560
Phone (616) 391-1774

2060 E Paris Ave SE
150 Centre for Plastic Surgery
Grand Rapids, MI 49546-6502
Phone (616) 454-1256

275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone (616) 391-3777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as group
Quality
85.52
Promoting interoperability
100
Improvement activities
40
Cost
57.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301508638MIMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Hospitals CurrentSince May 1, 2024 Accepting new patients
Spectrum Health Hospitals CurrentSince May 1, 2024 Accepting new patients
Grand Rapids Plastic Surgery PLC CurrentSince Aug 1, 2023 Accepting new patients
Ellen a. Janetzke, M.D., P.C. CurrentSince Apr 1, 2026 Accepting new patients

Locations

60 W Big Beaver Rd
Ste 100
Bloomfield Hills, MI 48304
Phone (248) 258-5100

330 Barclay Ave NE
Ste 104
Grand Rapids, MI 49503
Phone (616) 267-9823

2060 East Paris Ave SE
Ste 150
Grand Rapids, MI 49546
Phone (616) 454-1256

275 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7900

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

Interoperability endpoints

  • Direct secure messaging: rboston2850225@direct.trinity-health.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1073976213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W BIG BEAVER RD STE 100",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043913",
            "telephone_number": "248-258-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W BIG BEAVER RD STE 100",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043913",
            "telephone_number": "248-258-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "REBECCA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-04",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MI",
            "license": "4301508638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.