Individual provider Active NPI

Clarita Macatula, ANP-BC

  • Primary Care Nurse Practitioner
  • Commerce Township, MI
National Provider Identifier
1417313800
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2014021884 Issued in MI
Practice address
1990 Union Lake Rd Ste 100
Commerce Township, MI 48382-2200
Phone
(248) 363-7109
NPI assigned
Jan 14, 2016
Last updated
Jan 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2014021884 MI Primary

Addresses

Primary practice location

1990 Union Lake Rd Ste 100
Commerce Township, MI 48382-2200

Mailing address

1990 Union Lake Rd Ste 100
Commerce Township, MI 48382-2200
Phone (248) 363-7109

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
I20170426002279 MI Practitioner - Nurse Practitioner 1052558756 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014021884MIMDPrimary Care Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452729600000",
    "number": "1417313800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 UNION LAKE RD STE 100",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483822200",
            "telephone_number": "248-363-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 UNION LAKE RD STE 100",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483822200",
            "telephone_number": "248-363-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACATULA",
        "first_name": "CLARITA",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2016-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "2014021884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce Township, MI

Sources for this page

Verify at the official NPI Registry.