Paul A Renke, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

2901016821 Issued in MI

Practice address

1460 Walton Blvd
Ste 10
Rochester Hills, MI 48309

Phone

(248) 651-4202

Fax

(248) 651-4204

NPI assigned

Aug 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial Surgery

Education

Other, 1995

Medicare assignment

May accept Medicare assignment

Group practices

Rochester Hills Oms, P.C.Group PAC ID 3173779527, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: prenke1148898@direct.hfhs.org

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.

• Rochester Hills Oms, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Rochester Hills, MI
  • NPI 1366745119
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114935632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 WALTON BLVD",
            "address_2": "STE 10",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "48309",
            "telephone_number": "248-651-4202",
            "fax_number": "248-651-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 WALTON BLVD",
            "address_2": "STE 10",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "48309",
            "telephone_number": "248-651-4202",
            "fax_number": "248-651-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENKE",
        "first_name": "PAUL",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "2901016821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Heather Jo Reynolds, M.S., CCC-SLP

• Oral & Maxillofacial Surgery (D.M.D.) in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.