Individual provider Active NPI

Robert M Beck, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Woodhaven, MI
National Provider Identifier
1740757418
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704210906 Issued in MI
Practice address
21074 Tiffany Dr
Woodhaven, MI 48183-1620
Phone
(734) 972-0860
NPI assigned
Oct 30, 2018
Last updated
Oct 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704210906 MI Primary

Addresses

Primary practice location

21074 Tiffany Dr
Woodhaven, MI 48183-1620

Mailing address

21074 Tiffany Drive
Woodhaven, MI 48183
Phone (734) 972-0860

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
I20181205001025 MI Practitioner - Nurse Practitioner 5597009365 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704210906MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Apr 1, 2023 Accepting new patients
Vpa PC CurrentSince Apr 1, 2023 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Feb 14, 2025 Accepting new patients

Locations

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1740757418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21074 TIFFANY DRIVE",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "48183",
            "telephone_number": "734-972-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21074 TIFFANY DR",
            "city": "WOODHAVEN",
            "state": "MI",
            "postal_code": "481831620",
            "telephone_number": "734-972-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECK",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704210906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodhaven, MI

Sources for this page

Verify at the official NPI Registry.