Individual provider Active NPI

Andrew Rushlow

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1154858231
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
449 N Wendover Rd Ste a
Charlotte, NC 28211-1064
Phone
(704) 365-6730
Fax
(704) 365-6731
NPI assigned
May 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

449 N Wendover Rd Ste a
Charlotte, NC 28211-1064

Mailing address

1030 Harrington St
Ste 303
Mount Clemens, MI 48043-2967

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
I20190824000089 MI Practitioner - Physician Assistant 9234401035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McLaren MacombGroup PAC ID 8921912791, 131 clinicians

Practice addresses (Care Compare)

1000 Harrington St
Mount Clemens, MI 48043-2920
Phone (810) 493-8000

1030 Harrington St
Mount Clemens, MI 48043-2967

1030 Harrington St
Suite Ll001
Mount Clemens, MI 48043-2918
Phone (586) 493-3297

37399 Garfield Rd
Clinton Township, MI 48036-3672

Hospital & facility affiliations

  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227
  • McLaren Port Huron Hospital, Port Huron, MI, CCN 230216

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Macomb CurrentSince Aug 15, 2019 Accepting new patients

Locations

37399 Garfield Rd
Ste 203
Clinton Twp, MI 48036
Phone (586) 228-2911

1030 Harrington St
Ste 201
Mount Clemens, MI 48043
Phone (586) 493-1588

1030 Harrington St
Ste 303
Mount Clemens, MI 48043
Phone (248) 922-6810

Organizations & group practices 1

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 3

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": "1495152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1154858231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 HARRINGTON ST",
            "address_2": "STE 303",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 N WENDOVER RD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111064",
            "telephone_number": "704-365-6730",
            "fax_number": "704-365-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSHLOW",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-19",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.