Individual provider Active NPI

Renee Lynne Barry, MD

  • Plastic Surgery Physician
  • Clinton Township, MI
National Provider Identifier
1205363975
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
4301514455 Issued in MI
Practice address
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone
(586) 263-2300
NPI assigned
May 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301112153 MI
Plastic Surgery Physician 208200000X 4301514455 MI Primary

Addresses

Primary practice location

15855 19 Mile Rd
Clinton Township, MI 48038-3504

Mailing address

PO Box 670884
Detroit, MI 48267-0884
Phone (313) 874-4806

Other practice location 1

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484
Phone (734) 998-6022

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
I20250911004522 MI Practitioner - Plastic and Reconstructive Surgery 5890065338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Michigan State University College of Human Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484
Phone (734) 998-6022

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301514455MIMDPlastic Surgery Physician
4301112153MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Plastic Surgery CurrentSince Aug 12, 2025 Accepting new patients
Regents of the University of Michigan CurrentSince Aug 12, 2025 Accepting new patients
Regents of the University of Michigan Plastic Surgery Current Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

2098 S Main St
Ann Arbor, MI 48103
Phone (734) 936-5780

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

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 1

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": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1205363975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670884",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670884",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Frank Lloyd Wright Dr",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481059484",
            "country_code": "US",
            "telephone_number": "734-998-6022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRY",
        "first_name": "RENEE",
        "middle_name": "LYNNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-12",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301112153",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301514455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.