NPIMap

Individual provider Active NPI

Renae K McConnell, PA-C

  • Medical Physician Assistant
  • Farmington Hills, MI
National Provider Identifier
1780664474
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601003985 Issued in MI
Practice address
28080 Grand River Ave
Suite 300W
Farmington Hills, MI 48336-5966
Phone
(248) 615-7300
Fax
(248) 615-7333
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601003985 MI Primary

Addresses

Primary practice location

28080 Grand River Ave
Suite 300W
Farmington Hills, MI 48336-5966

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1862

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmcconnell96394@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051017000112 MI Practitioner - Physician Assistant 3870519150 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28080 Grand River Ave
Suite 306N
Farmington Hills, MI 48336-5966
Phone (947) 521-4771

28100 Grand River Ave
Farmington Hills, MI 48336-5970

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

Interoperability endpoints

  • Direct secure messaging: renae.mcconnell.1@21803.direct.athenahealth.com

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.

Hospital & facility affiliations 9

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1780664474",
    "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",
            "telephone_number": "947-522-1862",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28080 GRAND RIVER AVE",
            "address_2": "SUITE 300W",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365966",
            "telephone_number": "248-615-7300",
            "fax_number": "248-615-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "RENAE",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601003985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmcconnell96394@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "28080 Grand River Ave",
            "address_2": "Suite 300W",
            "city": "Farmington Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483365966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.