Individual provider Active NPI

Rajani Rupesh Kakade, APRN (FNP-BC)

  • Family Nurse Practitioner
  • West Bloomfield, MI
National Provider Identifier
1467182964
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704352619 Issued in MI
Practice address
4415 Crestdale Ave
West Bloomfield, MI 48323-1134
Phone
(248) 982-0756
NPI assigned
Jun 16, 2022
Last updated
Dec 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 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 4704352619 MI Primary

Addresses

Primary practice location

4415 Crestdale Ave
West Bloomfield, MI 48323-1134

Mailing address

18000 W 9 Mile Rd Ste 525
Southfield, MI 48075-4080
Phone (248) 327-6196

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
I20220817000644 MI Practitioner - Nurse Practitioner 2163805698 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Traveling Physician Services PC Nurse Practitioner CurrentSince Jun 2, 2025 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Dec 23, 2022 Accepting new patients
Integrated Visiting Physician Solutions PC CurrentSince Nov 8, 2023 Accepting new patients
Wellbridge of Clarkston, LLC Past Accepting new patients

Locations

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

18000 W 9 Mile Rd
Ste 525
Southfield, MI 48075
Phone (248) 327-6195

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.

NPI Registry JSON

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1467182964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 W 9 MILE RD STE 525",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754080",
            "telephone_number": "248-327-6196",
            "fax_number": "248-327-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 CRESTDALE AVE",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483231134",
            "telephone_number": "248-982-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAKADE",
        "first_name": "RAJANI",
        "middle_name": "RUPESH",
        "credential": "APRN (FNP-BC)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704352619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.