Individual provider Active NPI

Rebecca Stotz

  • Family Nurse Practitioner
  • Monroe, MI
National Provider Identifier
1386215200
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704294778 Issued in MI
Practice address
1420 N Monroe St
Monroe, MI 48162-4211
Phone
(734) 240-8480
Fax
(734) 384-0469
NPI assigned
Jul 2, 2021
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704294778 MI Primary

Addresses

Primary practice location

1420 N Monroe St
Monroe, MI 48162-4211

Mailing address

333 N Summit St FL 7
Toledo, OH 43604-1531

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rstotz95712@epicdirect.promedica.org

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
I20210928000574 MI Practitioner - Nurse Practitioner 1850798208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical College of Ohio, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Monroe PhysiciansGroup PAC ID 2365696176, 64 clinicians

Practice addresses (Care Compare)

1420 N Monroe St
Monroe, MI 48162-4211
Phone (734) 240-8480

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Aug 1, 2021 Accepting new patients
Promedica Monroe Physicians CurrentSince Apr 15, 2023 Accepting new patients
Promedica Central Physicians CurrentSince Aug 1, 2021 Accepting new patients
West Toledo Urgent Care LLC Past Accepting new patients

Locations

777 Kimole Ln
Ste 250
Adrian, MI 49221
Phone (517) 265-3411

3175 Smith Rd
Lambertville, MI 48144
Phone (734) 856-5494

1180 N Monroe St
Monroe, MI 48162
Phone (734) 243-5300

1420 N Monroe St
Monroe, MI 48162
Phone (734) 240-8480

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

333 N Summit St
Fl 7
Toledo, OH 43604
Phone (419) 252-5909

Interoperability endpoints

  • Direct secure messaging: rstotz95712@direct.promedica.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1386215200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N MONROE ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624211",
            "telephone_number": "734-240-8480",
            "fax_number": "734-384-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTZ",
        "first_name": "REBECCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2023-11-03",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704294778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rstotz95712@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.