Individual provider Active NPI

Natalie Gwen Rasak, PA-C

  • Physician Assistant
  • Southfield, MI
National Provider Identifier
1265075733
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009588 Issued in MI
Practice address
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone
(248) 849-3000
NPI assigned
Oct 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 5601009588 MI Primary

Addresses

Primary practice location

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Mailing address

37792 Bradley Dr
Farmington Hills, MI 48335-2706

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
I20200113002113 MI Practitioner - Physician Assistant 3870928286 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Hospitalist Physicians PLLCGroup PAC ID 3971874090, 61 clinicians
Independent Observation Physicians PLLCGroup PAC ID 3577603604, 138 clinicians

Practice addresses (Care Compare)

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

47601 Grand River Ave
Novi, MI 48374-1233
Phone (248) 465-4210

Hospital & facility affiliations

  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601009588MIMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: nrasak1148611@direct.hfhs.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": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1265075733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37792 BRADLEY DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483352706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASAK",
        "first_name": "NATALIE",
        "middle_name": "GWEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.