Individual provider Active NPI

Juan Rhoades

  • Nurse Practitioner
  • Rochester Hills, MI
National Provider Identifier
1851672166
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704249481 Issued in MI
Practice address
1460 Walton Blvd
Ste 200
Rochester Hills, MI 48309-1768
Phone
(248) 650-1800
Fax
(248) 650-1856
NPI assigned
Aug 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704249481 MI Primary

Addresses

Primary practice location

1460 Walton Blvd
Ste 200
Rochester Hills, MI 48309-1768

Mailing address

1460 Walton Blvd
Ste 200
Rochester Hills, MI 48309-1768
Phone (248) 650-1800

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
I20111003000545 MI Practitioner - Nurse Practitioner 0042482622 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brian T Gietzen MD PCGroup PAC ID 0840224564, 5 clinicians

Practice addresses (Care Compare)

1460 Walton
Suite 200
Rochester Hills, MI 48309-1779
Phone (248) 650-1800

Hospital & facility affiliations

  • Residential Home Health and Hospice Home health agency, Saginaw, MI, CCN 239152
  • Advisacare Solutions of Northern Michigan, LLC Home health agency, Charlevoix, MI, CCN 237042
  • McLaren Home Health Home health agency, Cheboygan, MI, CCN 237160
  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704249481MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mackinac Straits Health System Inc CurrentSince Jan 22, 2024 Accepting new patients
Bay Street Orthopaedics PLLC CurrentSince Jan 6, 2020 Accepting new patients
Bay Street Orthopaedics PLLC CurrentSince Jan 6, 2020 Accepting new patients
Mackinac Straits Health System Inc CurrentSince Jan 22, 2024 Accepting new patients

Locations

14715 W Upright St
Charlevoix, MI 49720
Phone (231) 347-5155

810 S Main St
Cheboygan, MI 49721
Phone (231) 627-9921

1050 S Otsego Ave
Gaylord, MI 49735
Phone (231) 347-5155

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

4048 Cedar Bluff Dr
Ste 1
Petoskey, MI 49770
Phone (231) 347-5155

573 N Bradley Hwy
Rogers City, MI 49779
Phone (989) 734-2171

1140 N State St
Saint Ignace, MI 49781
Phone (906) 643-0466

Organizations & group practices 6

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 6

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": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1851672166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 WALTON BLVD",
            "address_2": "STE 200",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483091768",
            "telephone_number": "248-650-1800",
            "fax_number": "248-650-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 WALTON BLVD",
            "address_2": "STE 200",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483091768",
            "telephone_number": "248-650-1800",
            "fax_number": "248-650-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHOADES",
        "first_name": "JUAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704249481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.