Active NPI
Rebekah Laine Vanaken, PA-C
- Physician Assistant
- Detroit, MI
National Provider Identifier
1316579154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601010283
- Practice address
- 13403 W 7 Mile Rd
Detroit, MI 48235-1387 - Phone
- (313) 308-2444
- NPI assigned
- Feb 10, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 5601010283 | MI | Primary |
Addresses
Primary practice location
13403 W 7 Mile Rd
Detroit, MI 48235-1387
Mailing address
13403 W 7 Mile Rd
Detroit, MI 48235-1387
Phone (313) 308-2444
Other practice location 1
1190 E 12 Mile Rd
Madison Heights, MI 48071-2648
Phone (248) 809-3631
Other practice location 2
1280 E Campus Dr
Mount Pleasant, MI 48859-2033
Phone (724) 815-5579
Other names 1
- Rebekah Laine Petty
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, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (810) 606-5733
2116 S Milford Rd
Highland, MI 48357-4609
Phone (248) 942-5888
21929 E 9 Mile Rd
Saint Clair Shores, MI 48080-2906
Phone (248) 942-5888
320 Town Ctr Blvd
Suite 101
White Lake, MI 48386-2183
9749 Dixie Hwy
Suite B
Clarkston, MI 48348-5406
Phone (248) 942-5888
Hospital & facility affiliations
- Ascension Genesys Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601010283 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Observation Medicine Group PLLC | Current | Accepting new patients |
Locations
1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733
Interoperability endpoints
- rebekah.vanaken.1@31854.direct.athenahealth.com
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.
-
- Emergency Medicine Physician
- Grand Blanc, MI
- NPI 1194084111
-
- Emergency Medicine Physician
- Grand Blanc, MI
- NPI 1275899171
-
- Urgent Care Clinic/Center
- Clarkston, MI
- NPI 1144747460
-
- Urgent Care Clinic/Center
- Detroit, MI
- NPI 1538704218
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Grand Blanc, MI
- NPI 1407877723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661472000000",
"number": "1316579154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13403 W 7 MILE RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482351387",
"telephone_number": "313-308-2444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13403 W 7 MILE RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482351387",
"telephone_number": "313-308-2444"
}
],
"practiceLocations": [
{
"address_1": "1190 E 12 Mile Rd",
"address_purpose": "LOCATION",
"city": "Madison Heights",
"state": "MI",
"postal_code": "480712648",
"country_code": "US",
"telephone_number": "248-809-3631",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1280 E Campus Dr",
"address_purpose": "LOCATION",
"city": "Mount Pleasant",
"state": "MI",
"postal_code": "488592033",
"country_code": "US",
"telephone_number": "724-815-5579",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANAKEN",
"first_name": "REBEKAH",
"middle_name": "LAINE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-10",
"last_updated": "2022-08-26",
"certification_date": "2022-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601010283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "REBEKAH",
"last_name": "PETTY",
"middle_name": "LAINE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.