Individual provider Active NPI

Ashley N Decraene, NP-C

  • Family Nurse Practitioner
  • Rochester, MI
National Provider Identifier
1609410976
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704290238 Issued in MI
Practice address
1000 W University Dr Ste 202
Rochester, MI 48307-1875
Phone
(248) 375-4033
Fax
(483) 754-0342
NPI assigned
Oct 30, 2019
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 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 4704290238 MI Primary

Addresses

Primary practice location

1000 W University Dr Ste 202
Rochester, MI 48307-1875

Mailing address

1000 W University Dr Ste 202
Rochester, MI 48307-1875
Phone (248) 375-4033

Other practice location 1

239 S Main St
Romeo, MI 48065-5130
Phone (248) 375-4033

Other identifiers 1

IdentifierTypeStateIssuer
4704290238OtherMIMI NP LICENSE

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
I20210528000639 MI Practitioner - Nurse Practitioner 7012316748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Consultants PLLCGroup PAC ID 6800803917, 3 clinicians

Practice addresses (Care Compare)

1030 Harrington St
302A
Mount Clemens, MI 48043-2967
Phone (586) 759-2005

Merit-based Incentive Payment System (MIPS)

Final score
98.83 of 100Reported as group
Quality
100
Improvement activities
40
Cost
96.09

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704290238MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Consultants PLLC CurrentSince Sep 16, 2024 Accepting new patients

Locations

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

1030 Harrington St
Ste 302A
Mount Clemens, MI 48043
Phone (586) 759-2005

Interoperability endpoints

  • Direct secure messaging: adecraene951090@direct.hfhs.org

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": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1609410976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W UNIVERSITY DR STE 202",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071875",
            "telephone_number": "248-375-4033",
            "fax_number": "483-754-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W UNIVERSITY DR STE 202",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071875",
            "telephone_number": "248-375-4033",
            "fax_number": "483-754-0342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "239 S Main St",
            "address_purpose": "LOCATION",
            "city": "Romeo",
            "state": "MI",
            "postal_code": "480655130",
            "country_code": "US",
            "telephone_number": "248-375-4033",
            "fax_number": "248-375-4034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECRAENE",
        "first_name": "ASHLEY",
        "middle_name": "N",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704290238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI NP LICENSE",
            "identifier": "4704290238",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

Verify at the official NPI Registry.