Individual provider Active NPI

Erin Rachel Vandenberg, PA-C

  • Physician Assistant
  • Troy, MI
National Provider Identifier
1700362704
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010111 Issued in MI
Practice address
44199 Dequindre Rd Ste 509
Troy, MI 48085-1128
Phone
(248) 964-1920
NPI assigned
Jul 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 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 5601010111 MI Primary
Physician Assistant 363A00000X MA059839 PA

Addresses

Primary practice location

44199 Dequindre Rd Ste 509
Troy, MI 48085-1128

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-5000

Other names 1

  • Erin Rachel Slazenberg Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address evandenberg167842@direct.geisinger.edu Direct
Direct Messaging Address evandenberg2398965@direct.beaumont.edu

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
I20210909001990 MI Practitioner - Physician Assistant 3375894991 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28100 Grand River Ave
Farmington Hills, MI 48336-5970

44199 Dequindre Rd
Troy, MI 48085-1128

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-0535

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
66.73
Promoting interoperability
100
Improvement activities
40
Cost
70.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601010111MIMDPhysician Assistant
MA059839PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Service Corporation CurrentSince Dec 1, 2024 Accepting new patients
Iha Health Services Corporation CurrentSince Dec 1, 2024 Accepting new patients

Locations

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

Interoperability endpoints

  • Direct secure messaging: evandenberg2398965@direct.beaumont.edu
  • Direct secure messaging: evandenberg1259911@epic00.shdirect.org

Organizations & group practices 4

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 4

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": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1700362704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44199 DEQUINDRE RD STE 509",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851128",
            "telephone_number": "248-964-1920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "ERIN",
        "middle_name": "RACHEL",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010111",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059839",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evandenberg167842@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 E Mountain Blvd",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187110027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evandenberg2398965@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44201 Dequindre Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "SLAZENBERG",
            "middle_name": "RACHEL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.