Anne Marie Fano Arevalo, MSN, RN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704274016 Issued in MI

Practice address

44725 Grand River Ave Ste 104
Novi, MI 48375-1024

Phone

(517) 882-3732

Fax

(517) 882-3633

NPI assigned

May 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Specialty

Nurse Practitioner

Education

Wayne State University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.annemariearevalo@150339.advancedmd-direct.com

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.

• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1295866135
  Medicare reassignment Care Compare group NPD
• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1104930130
  NPD

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1922486729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44725 GRAND RIVER AVE STE 104",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751024",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44725 GRAND RIVER AVE STE 104",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751024",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AREVALO",
        "first_name": "ANNE MARIE",
        "middle_name": "FANO",
        "credential": "MSN, RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704274016",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704274016",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penny Ardissone
• Sophia K Arellanes
• Mayte Arellano Diaz
• Jose Arellano
• Carissa Arens
• Mariah Argiero
• Marcos Nick Arguello
• Kathryn Arias
• Salma Arif
• Melissa J Armbruster, M.A. LLP

• Psychiatric/Mental Health Nurse Practitioner in Novi, MI
• Providers in Novi, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.