Erin Rubeck, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601011223 Issued in MI

Practice address

6227 Frankfort Hwy
Benzonia, MI 49616-8632

Phone

(231) 882-9661

NPI assigned

Oct 19, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Crystal Lake Clinic PC

  • Family Medicine Physician
  • Manistee, MI
  • NPI 1134491731
  Medicare reassignment NPD
• Crystal Lake Clinic P.C.

  • Family Medicine Physician
  • Suttons Bay, MI
  • NPI 1164945978
  NPD
• Crystal Lake Clinic, P.C.

  • Family Medicine Physician
  • Bear Lake, MI
  • NPI 1902851777
  NPD (past)

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1750007845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6227 FRANKFORT HWY",
            "city": "BENZONIA",
            "state": "MI",
            "postal_code": "496168632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6227 FRANKFORT HWY",
            "city": "BENZONIA",
            "state": "MI",
            "postal_code": "496168632",
            "telephone_number": "231-882-9661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 E 7th St",
            "address_purpose": "LOCATION",
            "city": "Manton",
            "state": "MI",
            "postal_code": "496639429",
            "country_code": "US",
            "telephone_number": "231-824-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "93 W 4th St Ste B",
            "address_purpose": "LOCATION",
            "city": "Suttons Bay",
            "state": "MI",
            "postal_code": "496828408",
            "country_code": "US",
            "telephone_number": "231-866-4440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5191 Rosewood Dr",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496859137",
            "country_code": "US",
            "telephone_number": "231-922-0667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4025 Chums Village Dr",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496856992",
            "country_code": "US",
            "telephone_number": "231-642-5560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "124 Ames St",
            "address_purpose": "LOCATION",
            "city": "Elk Rapids",
            "state": "MI",
            "postal_code": "496299449",
            "country_code": "US",
            "telephone_number": "231-264-9060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2198 US 31 S",
            "address_purpose": "LOCATION",
            "city": "Manistee",
            "state": "MI",
            "postal_code": "496609618",
            "country_code": "US",
            "telephone_number": "231-723-3567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "826 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "MI",
            "postal_code": "496359003",
            "country_code": "US",
            "telephone_number": "231-352-5285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1975 Stirling Dr",
            "address_purpose": "LOCATION",
            "city": "Interlochen",
            "state": "MI",
            "postal_code": "496439264",
            "country_code": "US",
            "telephone_number": "231-275-7965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2283 E M 113",
            "address_purpose": "LOCATION",
            "city": "Kingsley",
            "state": "MI",
            "postal_code": "496499370",
            "country_code": "US",
            "telephone_number": "231-263-0700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8225 Lake St",
            "address_purpose": "LOCATION",
            "city": "Bear Lake",
            "state": "MI",
            "postal_code": "496149612",
            "country_code": "US",
            "telephone_number": "231-864-3314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBECK",
        "first_name": "ERIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011223",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "5601011223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lesa Dawn Rice, MSW
• Pamela Ringley
• Shelley Robinson
• Robin Evonne Ronk
• Kevin Rosenbrook
• George B Ryckman, D.O.
• Nicole Shively
• Rob Kenneth Slate, PT, DPT
• Amanda M Smith, MD
• Kyle S Smith, LBSW

• Physician Assistant in Benzonia, MI
• Providers in Benzonia, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.