NPIMap

Individual provider Active NPI

Brandon Bruce Redoute, PA-C

  • Medical Physician Assistant
  • Clinton TWP, MI
National Provider Identifier
1386113215
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
37150 S Gratiot Ave
Clinton TWP, MI 48036-2702
Phone
(586) 267-1334
NPI assigned
Nov 21, 2018
Last updated
Nov 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

37150 S Gratiot Ave
Clinton TWP, MI 48036-2702

Mailing address

23516 Harvard Shore Dr
Clinton Township, MI 48035-4339
Phone (586) 214-5028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190103002527 MI Practitioner - Physician Assistant 5890031306 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arcturus Healthcare PLCGroup PAC ID 7012143118, 63 clinicians

Practice addresses (Care Compare)

1701 S Blvd E
Rochester Hills, MI 48307-6116

4600 Investment Dr
Troy, MI 48098-6368
Phone 24826750003025

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.58 of 100Reported as group
Quality
82.27
Promoting interoperability
100
Improvement activities
40
Cost
69.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Urgent Care PC CurrentSince Mar 19, 2020 Accepting new patients
Arcturus Healthcare PLC CurrentSince Feb 1, 2021 Accepting new patients
Macomb Oakland Adult Medicine PC Current Accepting new patients
Farmington Hills Urgent Care Walk-in Clinic PC PastSince Jul 31, 2022 Accepting new patients

Locations

1701 South Blvd E
Ste 290
Rochester Hills, MI 48307
Phone (248) 997-7000

23234 Ecorse Rd
Taylor, MI 48180
Phone (313) 292-8400

4600 Investment Dr
Ste 300
Troy, MI 48098
Phone (248) 267-5000

4967 Crooks Rd
Ste 110
Troy, MI 48098
Phone (248) 267-5000

Interoperability endpoints

  • Direct secure messaging: brandonredoute@timpc.allscriptsdirect.net
  • Direct secure messaging: bredoute494961@direct.hfhs.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 6

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": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1386113215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23516 HARVARD SHORE DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480354339",
            "telephone_number": "586-214-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37150 S GRATIOT AVE",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480362702",
            "telephone_number": "586-267-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDOUTE",
        "first_name": "BRANDON",
        "middle_name": "BRUCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

Verify at the official NPI Registry.