Individual provider Active NPI

Rebecca Ellen Osterhout, PHD

  • Psychologist
  • Ann Arbor, MI
National Provider Identifier
1417281072
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-9118
Phone
(607) 725-6870
NPI assigned
Sep 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-9118

Mailing address

2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-9118
Phone (607) 725-6870

Other identifiers 1

IdentifierTypeStateIssuer
OH12447OtherMIBCBSM PIN

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191111000838 MI Practitioner - Clinical Psychologist 9931531100 Practice locations: Ann Arbor, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-9118
Phone 73499551817230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1417281072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2395 OAK VALLEY DR",
            "address_2": "SUITE 100",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039118",
            "telephone_number": "607-725-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 OAK VALLEY DR",
            "address_2": "SUITE 100",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039118",
            "telephone_number": "607-725-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTERHOUT",
        "first_name": "REBECCA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-29",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "OH12447",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.