Individual provider Active NPI

Raleigh D Eckert, PA, MSPH

  • Physician Assistant
  • Grosse Pointe Farms, MI
National Provider Identifier
1487139929
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010051 Issued in MI
Practice address
18700 Mack Ave
Grosse Pointe Farms, MI 48236-2923
Phone
(313) 925-3486
NPI assigned
Oct 1, 2018
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601010051 MI Primary

Addresses

Primary practice location

18700 Mack Ave
Grosse Pointe Farms, MI 48236-2923

Mailing address

273 McMillan Rd
Grosse Pointe Farms, MI 48236-3457
Phone (313) 408-4214

Other practice location 1

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 234-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181119000750 NC Practitioner - Physician Assistant 6103170709 Reassigns benefits to 1 organization
I20210113001554 MI Practitioner - Physician Assistant 6103170709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

18700 Mack Ave
Grosse Pointe Farms, MI 48236-2923
Phone (313) 925-3486

18930 W Rd
Beaumont Urgent Care of Michigan
Woodhaven, MI 48183-3317
Phone (734) 671-4900

2078 E Big Beaver Rd
Beaumont Urgent Care of Michigan
Troy, MI 48083-2301
Phone (248) 918-0744

25631 Little Mack Ave
Suite 104
Saint Clair Shores, MI 48081-2100
Phone (586) 884-2727

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Aug 22, 2019 Accepting new patients
Wellstreet Urgent Care of Michigan CurrentSince Sep 10, 2023 Accepting new patients
Wakemed Specialists Group, LLC CurrentSince Aug 22, 2019 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients

Locations

1825 Highway 34 E
Ste 1200
Newnan, GA 30265
Phone (770) 502-2112

18700 Mack Ave
Grosse Pointe Farms, MI 48236
Phone (313) 925-3486

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Organizations & group practices 6

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 4

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": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1487139929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 MCMILLAN RD",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363457",
            "telephone_number": "313-408-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 MACK AVE",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482362923",
            "telephone_number": "313-925-3486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 New Bern Ave",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101231",
            "country_code": "US",
            "telephone_number": "919-234-6440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECKERT",
        "first_name": "RALEIGH",
        "middle_name": "D",
        "credential": "PA, MSPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Farms, MI

Sources for this page

Verify at the official NPI Registry.