Active NPI
Marcine Renee Walter, P.A.-C.
- Physician Assistant
- Riverview, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601004073
- Practice address
- 19020 Fort St
Riverview, MI 48193-6701 - Phone
- (734) 362-5100
- Fax
- (734) 362-5147
- NPI assigned
- Nov 10, 2006
- Last updated
- Aug 26, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601004073 | MI | Primary |
Addresses
Primary practice location
19020 Fort St
Riverview, MI 48193-6701
Mailing address
19020 Fort St
Riverview, MI 48193-6701
Phone (734) 362-5100
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2116 S Milford Rd
Highland, MI 48357-4609
Phone (248) 942-5888
320 Town Ctr Blvd
Suite 101
White Lake, MI 48386-2183
9547 Chilson CMNS
Pinckney, MI 48169-9598
Phone (248) 942-5888
9749 Dixie Hwy
Suite B
Clarkston, MI 48348-5406
Phone (248) 942-5888
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- marcine.walter.1@31854.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Urgent Care Clinic/Center
- Clarkston, MI
- NPI 1144747460
-
- Clinic/Center
- Riverview, MI
- NPI 1184677866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219708800000",
"number": "1245301597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19020 FORT ST",
"city": "RIVERVIEW",
"state": "MI",
"postal_code": "481936701",
"telephone_number": "734-362-5100",
"fax_number": "734-362-5147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19020 FORT ST",
"city": "RIVERVIEW",
"state": "MI",
"postal_code": "481936701",
"telephone_number": "734-362-5100",
"fax_number": "734-362-5147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTER",
"first_name": "MARCINE",
"middle_name": "RENEE",
"credential": "P.A.-C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-10",
"last_updated": "2008-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601004073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.