Individual provider Active NPI

Stephanie Rose Menon, MD

  • Obstetrics & Gynecology Physician
  • Ann Arbor, MI
National Provider Identifier
1235440348
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301104628 Issued in MI
Practice address
4200 Whitehall Dr
Suite 330
Ann Arbor, MI 48105-9694
Phone
(734) 434-0477
Fax
(734) 434-6240
NPI assigned
Jun 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 125.057882 IL
Obstetrics & Gynecology Physician 207V00000X 4301104628 MI Primary

Addresses

Primary practice location

4200 Whitehall Dr
Suite 330
Ann Arbor, MI 48105-9694

Mailing address

24 Frank Lloyd Wright Dr
PO Box 0446 Lobby J
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Other names 1

  • Stephanie Rose Vitale Former name

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
I20140623000094 MI Practitioner - Obstetrics/Gynecology 7214151869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Michigan Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

4200 Whitehall Dr
Ann Arbor, MI 48105-9694

49650 Cherry Hill Rd
Suite 120
Canton, MI 48187-4850
Phone (734) 398-7800

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.057882ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Obstetrics & Gynecology Current Accepting new patients
Iha Health Services Corporation Obstetrics & Gynecology CurrentSince Aug 1, 2014 Accepting new patients
Iha Health Service Corporation Obstetrics & Gynecology CurrentSince Aug 1, 2014 Accepting new patients

Locations

4200 Whitehall Dr
Ste 330
Ann Arbor, MI 48105
Phone (734) 434-0477

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

49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

4990 W Clark Rd
Ste 200
Ypsilanti, MI 48197
Phone (734) 572-7500

4940 W Clark Rd
Ste 100
Ypsilanti, MI 48197
Phone (734) 434-0477

Interoperability endpoints

  • Direct secure messaging: smenon37110@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 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": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1235440348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "PO BOX 0446 LOBBY J",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 WHITEHALL DR",
            "address_2": "SUITE 330",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059694",
            "telephone_number": "734-434-0477",
            "fax_number": "734-434-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "STEPHANIE",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-24",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125.057882",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301104628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "VITALE",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.