Individual provider Active NPI

Lauren Elizabeth Brush, PA-C

  • Physician Assistant
  • Warren, MI
National Provider Identifier
1629406434
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007610 Issued in MI
Practice address
13850 E 12 Mile Rd
Warren, MI 48088-3730
Phone
(586) 552-4499
Fax
(586) 552-4878
NPI assigned
Oct 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003910 OH
Physician Assistant 363A00000X 5601007610 MI Primary

Addresses

Primary practice location

13850 E 12 Mile Rd
Warren, MI 48088-3730

Mailing address

13850 E 12 Mile Rd
Warren, MI 48088-3730
Phone (586) 552-4499

Other names 1

  • Miss Lauren Elizabeth Potestato Former name

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
I20160315001290 MI Practitioner - Physician Assistant 7810124377 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Physical Medicine and Rehabilitation PCGroup PAC ID 0143111658, 9 clinicians

Practice addresses (Care Compare)

13850 E 12 Mile Rd
Warren, MI 48088-3730
Phone (586) 552-4499

Hospital & facility affiliations

  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195

Merit-based Incentive Payment System (MIPS)

Final score
97.52 of 100Reported as group
Quality
90.31
Promoting interoperability
98
Improvement activities
40
Cost
76.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601007610MIMDPhysician Assistant
50.003910OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Physical Medicine & Rehabilitation PC CurrentSince Jul 9, 2016 Accepting new patients
Healthspan Physicians LLC Past Accepting new patients

Locations

13850 E 12 Mile Rd
Warren, MI 48088
Phone (586) 552-4499

Interoperability endpoints

  • Direct secure messaging: lbrush1119245@direct.hfhs.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1381795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1629406434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13850 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883730",
            "telephone_number": "586-552-4499",
            "fax_number": "248-552-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13850 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883730",
            "telephone_number": "586-552-4499",
            "fax_number": "586-552-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUSH",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-15",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003910",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "POTESTATO",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.