Individual provider Active NPI

Bekeza Ratliff, AGPCNP-BC

  • Primary Care Nurse Practitioner
  • Berkley, MI
National Provider Identifier
1235679192
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704285075 Issued in MI
Practice address
2635 Coolidge Hwy
Berkley, MI 48072-1554
Phone
(248) 541-2512
NPI assigned
Feb 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704285075 MI
Primary Care Nurse Practitioner 363LP2300X 4704285075 MI Primary

Addresses

Primary practice location

2635 Coolidge Hwy
Berkley, MI 48072-1554

Mailing address

13630 Grandview Dr
Gibraltar, MI 48173-9719
Phone (734) 493-2403

Other practice location 1

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (800) 653-6568

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
I20171201000544 MI Practitioner - Nurse Practitioner 8325305238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Nov 9, 2021 Accepting new patients
Henry Ford Health System Nurse Practitioner CurrentSince Nov 9, 2021 Accepting new patients
Personal Health Care, P.C. PastSince Jul 10, 1990 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients
Progressive Health Care, P.C. PastSince Feb 15, 2013 Accepting new patients

Locations

2799 W Grand Blvd
#6
Detroit, MI 48202
Phone (313) 916-3879

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

Interoperability endpoints

  • Direct secure messaging: bratliff755010@direct.hfhs.org

Organizations & group practices 5

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": "1488067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1235679192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13630 GRANDVIEW DR",
            "city": "GIBRALTAR",
            "state": "MI",
            "postal_code": "481739719",
            "telephone_number": "734-493-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 COOLIDGE HWY",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721554",
            "telephone_number": "248-541-2512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "800-653-6568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RATLIFF",
        "first_name": "BEKEZA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-26",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704285075",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704285075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.