Kendall Morgan Rabaut, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704370391 Issued in MI

Practice address

20030 Mack Ave
Grosse Pointe Woods, MI 48236-2323

Phone

(313) 884-3380

Fax

(313) 884-9756

NPI assigned

Aug 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lisa a Manz Dulac MD and Associates PCGroup PAC ID 4880666429, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lisa a Manz Dulac MD & Associates PC

  • Specialist
  • Grosse Pointe Woods, MI
  • NPI 1326007956
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1093545857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22978 CAROLINA ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802506",
            "telephone_number": "586-894-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20030 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362323",
            "telephone_number": "313-884-3380",
            "fax_number": "313-884-9756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32743 23 Mile Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MI",
            "postal_code": "480472176",
            "country_code": "US",
            "telephone_number": "313-884-3380",
            "fax_number": "313-884-9756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RABAUT",
        "first_name": "KENDALL",
        "middle_name": "MORGAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704370391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Prush
• Indya Diane Purry
• Khin Sandar Pyai, MD
• Carol J Quinn, DDS
• Kiara Adeliz Qujano Gomez
• Anna N Rabbani, M.D.
• Melissa Radner, MPT
• Jocelyn Rainey
• Jessica Randolph
• Paul G Raubolt, DDS

• Nurse Practitioner in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.

Verify at the official NPI Registry.