Individual provider Active NPI

Rachael Marie Khodl, PA-C

  • Physician Assistant
  • Muskegon, MI
National Provider Identifier
1093412215
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1150 E Sherman Blvd Ste 2400
Muskegon, MI 49444-1886
Phone
(231) 672-4243
Fax
(231) 727-4214
NPI assigned
Feb 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1150 E Sherman Blvd Ste 2400
Muskegon, MI 49444-1886

Mailing address

1150 E Sherman Blvd Ste 2400
Muskegon, MI 49444-1886
Phone (231) 672-4243

Other practice location 1

1675 Leahy St Ste 401
Muskegon, MI 49442-5544
Phone (231) 728-4243

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230228000953 MI Practitioner - Physician Assistant 3072986769 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Partners - Physician SpecialistGroup PAC ID 2163572991, 66 clinicians

Practice addresses (Care Compare)

1150 E Sherman Blvd
Suite 2400
Muskegon, MI 49444-1886
Phone (231) 672-4243

1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone (231) 672-3027

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.47
Improvement activities
40
Cost
69.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Shore Cardiology, PLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rkhodl2623799@direct.trinity-health.org

Organizations & group practices 3

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": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1093412215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 E SHERMAN BLVD STE 2400",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441886",
            "telephone_number": "231-672-4243",
            "fax_number": "231-727-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E SHERMAN BLVD STE 2400",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441886",
            "telephone_number": "231-672-4243",
            "fax_number": "231-727-4214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Leahy St Ste 401",
            "address_purpose": "LOCATION",
            "city": "Muskegon",
            "state": "MI",
            "postal_code": "494425544",
            "country_code": "US",
            "telephone_number": "231-728-4243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHODL",
        "first_name": "RACHAEL",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.