Individual provider Active NPI

Jane E Elenbaas, NP

  • Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1669742920
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704248722 Issued in MI
Practice address
1500 E Medical Center Drive
2ND Floor Taubman Center Dr
Ann Arbor, MI 48109-5338
Phone
(734) 936-7010
NPI assigned
Jan 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704248722 MI Primary

Addresses

Primary practice location

1500 E Medical Center Drive
2ND Floor Taubman Center Dr
Ann Arbor, MI 48109-5338

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

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
I20120410000014 MI Practitioner - Nurse Practitioner 9537320007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Dec 25, 2011 Accepting new patients
Regents of the University of Michigan Nurse Practitioner CurrentSince Dec 25, 2011 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

325 E Eisenhower Pkwy
Ste 100
Ann Arbor, MI 48108
Phone (734) 763-5459

1500 E Medical Center Dr
Fl 2
Ann Arbor, MI 48109
Phone (734) 936-5738

4260 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 647-5715

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
#700
Ann Arbor, MI 48108

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 6

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": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1669742920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE",
            "address_2": "2ND FLOOR TAUBMAN CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095338",
            "telephone_number": "734-936-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELENBAAS",
        "first_name": "JANE",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704248722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.