Individual provider Active NPI

Rita U Antani, PSYD

  • Clinical Psychologist
  • Rochester Hills, MI
National Provider Identifier
1649215872
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301008402 Issued in MI
Practice address
2820 Crooks Rd Ste 100
Rochester Hills, MI 48309-3620
Phone
(248) 931-3176
Fax
(248) 289-6540
NPI assigned
Jun 19, 2006
Last updated
Jul 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301008402 MI Primary

Addresses

Primary practice location

2820 Crooks Rd Ste 100
Rochester Hills, MI 48309-3620

Mailing address

PO Box 70092
Rochester Hills, MI 48307-0002
Phone (248) 931-3176

Other identifiers 1

IdentifierTypeStateIssuer
680F332027OtherMIBLUE CROSS MICHIGAN

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040806001250 MI Practitioner - Clinical Psychologist 8022080480 Practice locations: Rochester Hills, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

705 Barclay Cir
Suite 115
Rochester Hills, MI 48307-4575
Phone (248) 931-3176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Clinic of Michigan PC Past Accepting new patients
Rita U Antani PSYD PLC Clinical PastSince Oct 1, 1997 Accepting new patients

Organizations & group practices 2

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1649215872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70092",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483070002",
            "telephone_number": "248-931-3176",
            "fax_number": "888-909-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 CROOKS RD STE 100",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093620",
            "telephone_number": "248-931-3176",
            "fax_number": "248-289-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTANI",
        "first_name": "RITA",
        "middle_name": "U",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301008402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MICHIGAN",
            "identifier": "680F332027",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.