NPIMap

Individual provider Active NPI

Nicole Rebecca Robertson, M.D.

  • Family Medicine Physician
  • Pinckney, MI
National Provider Identifier
1922361302
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301101513 Issued in MI
Practice address
1255 E M 36
Pinckney, MI 48169-8133
Phone
(734) 878-1000
Fax
(734) 878-1001
NPI assigned
Jun 20, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301101513 MI Primary

Addresses

Primary practice location

1255 E M 36
Pinckney, MI 48169-8133

Mailing address

1255 E M 36
Pinckney, MI 48169-8133
Phone (734) 878-1000

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
I20150921000363 MI Practitioner - Family Practice 1456583830 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Olma Primary Non Risk LLCGroup PAC ID 1759792799, 16 clinicians

Practice addresses (Care Compare)

37595 7 Mile Rd
Suite 210
Livonia, MI 48152-1489
Phone (734) 853-5694

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Olma Primary Non Risk LLC Family Medicine CurrentSince Apr 6, 2023 Accepting new patients
Mercy Memorial Hospital Corporation CurrentSince Jan 1, 2016 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Olma Primary Non Risk LLC Family Medicine CurrentSince Apr 6, 2023 Accepting new patients
Promedica Central Corporation of Michigan Family Medicine CurrentSince Aug 16, 2015 Accepting new patients
Mercy Memorial Hospital Corporation Family Medicine CurrentSince Jan 1, 2016 Accepting new patients
Mercy Memorial Hospital Corporatio Current Accepting new patients
Iha Health Service Corporation CurrentSince Jun 1, 2017 Accepting new patients
Iha Health Services Corporation Family Medicine CurrentSince Jun 1, 2017 Accepting new patients

Locations

818 Riverside Ave
Adrian, MI 49221
Phone (517) 263-0711

901 Kimole Ln
Ste A4
Adrian, MI 49221
Phone (517) 263-6140

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

20206 Farmington Rd
Livonia, MI 48152
Phone (248) 471-6585

37595 7 Mile Rd
Ste 210
Livonia, MI 48152
Phone (734) 432-7282

650 Stewart Rd
Monroe, MI 48162
Phone (734) 240-4594

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

905 N Macomb St
Ste 2
Monroe, MI 48162
Phone (734) 242-1899

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

200 E Russell Rd
Unit C
Tecumseh, MI 49286
Phone (517) 424-3883

500 E Pottawatamie St
Tecumseh, MI 49286
Phone (517) 266-0525

Interoperability endpoints

  • Direct secure messaging: nrobertson25899@direct.trinity-health.org

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1922361302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 E M 36",
            "city": "PINCKNEY",
            "state": "MI",
            "postal_code": "481698133",
            "telephone_number": "734-878-1000",
            "fax_number": "734-878-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 E M 36",
            "city": "PINCKNEY",
            "state": "MI",
            "postal_code": "481698133",
            "telephone_number": "734-878-1000",
            "fax_number": "734-878-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "NICOLE",
        "middle_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301101513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinckney, MI

Sources for this page

Verify at the official NPI Registry.