Individual provider Active NPI

Rebecca Broome, LMSW

  • Clinical Social Worker
  • Brighton, MI
National Provider Identifier
1710012836
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801088507 Issued in MI
Practice address
8010 Grand River Rd Ste 100
Brighton, MI 48114-9303
Phone
(810) 207-5725
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801088507 MI Primary

Addresses

Primary practice location

8010 Grand River Rd Ste 100
Brighton, MI 48114-9303

Mailing address

10335 Cedarcrest Rd
Whitmore Lake, MI 48189-9396
Phone (810) 207-5725

Other practice location 1

10335 Cedarcrest Rd
Whitmore Lake, MI 48189-9396
Phone (810) 207-5725

Other identifiers 1

IdentifierTypeStateIssuer
730195MedicaidMI

Other names 1

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110319000015 MI Practitioner - Clinical Social Worker 0547443160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anchor Point of Hope Counseling Services PCGroup PAC ID 7012333545, 7 clinicians

Practice addresses (Care Compare)

10335 Cedarcrest Rd
Whitmore Lake, MI 48189-9396
Phone (810) 207-5725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801088507MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anchor Point of Hope Counseling Services PC Clinical CurrentSince Jun 1, 2020 Accepting new patients

Locations

211 N 1st St
Ste 206
Brighton, MI 48116
Phone (810) 207-5725

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1710012836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10335 CEDARCREST RD",
            "city": "WHITMORE LAKE",
            "state": "MI",
            "postal_code": "481899396",
            "telephone_number": "810-207-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 GRAND RIVER RD STE 100",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481149303",
            "telephone_number": "810-207-5725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10335 Cedarcrest Rd",
            "address_purpose": "LOCATION",
            "city": "Whitmore Lake",
            "state": "MI",
            "postal_code": "481899396",
            "country_code": "US",
            "telephone_number": "810-207-5725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOME",
        "first_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "730195",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BONTUMASI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brighton, MI

Sources for this page

Verify at the official NPI Registry.