Individual provider Active NPI

Robyn Renee Fryc

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1699250001
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012625 Issued in MI
Practice address
311 Mack Ave FL 5
Detroit, MI 48201-2466
Phone
(313) 832-0500
Fax
(313) 966-8400
NPI assigned
Oct 2, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 5601012625 MI Primary

Addresses

Primary practice location

311 Mack Ave FL 5
Detroit, MI 48201-2466

Mailing address

311 Mack Ave FL 5
Detroit, MI 48201-2466
Phone (313) 832-0500

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
I20241009000701 MI Practitioner - Physician Assistant 5890226211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

3901 Beaubien 1St Floor
Detroit, MI 48201-2119
Phone (313) 745-5227

3901 Beaubien St
Detroit, MI 48201-2119

3990 John R St
Detroit, MI 48201-2018

National Provider Directory

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

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1699250001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 MACK AVE FL 5",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012466",
            "telephone_number": "313-832-0500",
            "fax_number": "313-966-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MACK AVE FL 5",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012466",
            "telephone_number": "313-832-0500",
            "fax_number": "313-966-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYC",
        "first_name": "ROBYN",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.