Rachael Elizabeth Ustruck, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101017009 Issued in MI

Practice address

1200 W 12 Mile Rd
Madison Heights, MI 48071-4439

Phone

(248) 543-0600

Fax

(248) 543-4720

NPI assigned

Apr 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Rachael Elizabeth Kokkinos Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Lake Erie College of Osteopathic Medicine, Erie, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rachael.ustruck.1@26235.direct.athenahealth.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Michigan Healthcare Professionals PC

  • Diagnostic Radiology Physician
  • Westland, MI
  • NPI 1043559404
  NPD
• Michigan Healthcare Professionals PC

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1467574541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W 12 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480714439",
            "telephone_number": "248-543-0600",
            "fax_number": "248-543-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W 12 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480714439",
            "telephone_number": "248-543-0600",
            "fax_number": "248-543-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "USTRUCK",
        "first_name": "RACHAEL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101017009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467574541",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHAEL",
            "last_name": "KOKKINOS",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter George Tucker, MD
• Jerone Derocco Turner Jr.
• Uma Rehabilitation and Physical Therapy Center, Inc.
• Universal Durable Medical Equipment, LLC
• University Neurosurgical Associates, PC
• V Care Physcial Therapy Inc
• Value Center Pharmacy Inc
• Jerroid Vann-Robertson Vann-Robertson
• Nancy Louise Veenstra, OT
• Velton D. Robinson DDS

• Family Medicine Physician in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.