Individual provider Active NPI

Rachel Poterek, CRNA

  • Certified Registered Nurse Anesthetist
  • Royal Oak, MI
National Provider Identifier
1740257237
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704216982 Issued in MI
Practice address
3601 W. 13 Mile Rd
400 FSC-PCS
Royal Oak, MI 48073-6769
Phone
(248) 423-2481
NPI assigned
Mar 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704216982 MI Primary

Addresses

Primary practice location

3601 W. 13 Mile Rd
400 FSC-PCS
Royal Oak, MI 48073-6769

Mailing address

3601 W. 13 Mile Rd
400 FSC-PCS
Royal Oak, MI 48073-6769
Phone (248) 423-2481

Other identifiers 2

IdentifierTypeStateIssuer
4547577MedicaidMI
4304364420OtherMIBCBSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031204000925 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800791526 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Lake Anesthesiology Consultants PLCGroup PAC ID 7113818980, 94 clinicians

Practice addresses (Care Compare)

4550 Investment Dr
Troy, MI 48098-6334
Phone (248) 265-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Long Lake Anesthesiology Consultants, PLC CurrentSince Aug 1, 2024 Accepting new patients
William Beaumont Hospital CurrentSince May 5, 2003 Accepting new patients
William Beaumont Hospital Nurse Anesthetist, Certified Registered CurrentSince May 5, 2003 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Superior Anesthetists Associates, Inc. CurrentSince Oct 17, 2018 Accepting new patients
Paragon Anesthesia PLLC CurrentSince Nov 25, 2020 Accepting new patients
Apex Anesthesia Services PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2009 Momentum Pl
Chicago, IL 60689

5701 Bow Pointe Dr
Ste 145
Clarkston, MI 48346
Phone (248) 922-4800

5202 Miller Rd
Flint, MI 48507
Phone (810) 720-8900

920 River Centre Dr
Port Huron, MI 48060
Phone (810) 984-5200

3601 W 13 Mile Rd
#400
Royal Oak, MI 48073
Phone (248) 423-2481

3601 W 13 Mile Rd
Royal Oak, MI 48073

26051 Lahser Rd
Southfield, MI 48033
Phone (248) 223-9925

4550 Investment Dr
Troy, MI 48098
Phone (248) 265-4600

4550 Investment Dr
Ste 100
Troy, MI 48098
Phone (248) 265-4600

130 Town Center Dr
Ste 203
Troy, MI 48084
Phone (248) 585-8250

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Organizations & group practices 7

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1740257237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W. 13 MILE RD",
            "address_2": "400 FSC-PCS",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736769",
            "telephone_number": "248-423-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W. 13 MILE RD",
            "address_2": "400 FSC-PCS",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736769",
            "telephone_number": "248-423-2481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTEREK",
        "first_name": "RACHEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704216982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4547577",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSC",
            "identifier": "4304364420",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.