Individual provider Active NPI

Rachel Tibaudo, FNP

  • Family Nurse Practitioner
  • Sterling Heights, MI
National Provider Identifier
1932637022
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704289816 Issued in MI
Practice address
43455 Schoenherr Rd Ste 2
Sterling Heights, MI 48313-1972
Phone
(586) 726-4823
NPI assigned
Jun 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704289816 MI Primary

Addresses

Primary practice location

43455 Schoenherr Rd Ste 2
Sterling Heights, MI 48313-1972

Mailing address

43455 Schoenherr Rd Ste 2
Sterling Heights, MI 48313-1972
Phone (989) 513-0922

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
I20170629000323 MI Practitioner - Nurse Practitioner 8325317795 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Pine Medical Group PLC CurrentSince Jul 3, 2017 Accepting new patients
Bayside Family Medicine Chesterfield PC PastSince Oct 6, 2009 Accepting new patients

Locations

31225 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 598-2900

36555 26 Mile Rd
Ste 2500
Lenox, MI 48048

48801 Romeo Plank Rd
Ste 103
Macomb, MI 48044

15959 Hall Rd
Ste 110
Macomb, MI 48044

53950 Van Dyke Ave
Shelby Township, MI 48316
Phone (248) 293-0055

13860 Canal Rd
Sterling Heights, MI 48313
Phone (248) 254-8900

43455 Schoenherr Rd
Ste 2
Sterling Hts, MI 48313
Phone (586) 884-2712

43455 Schoenherr Rd
Sterling Hts, MI 48313
Phone (248) 373-7600

57850 Van Dyke Rd
Ste 100
Washington Twp, MI 48094
Phone (586) 203-2020

Interoperability endpoints

  • Direct secure messaging: rfillmore466058@direct.hfhs.org
  • Direct secure messaging: racheltibaudo@spmgsh.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1932637022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43455 SCHOENHERR RD STE 2",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131972",
            "telephone_number": "989-513-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43455 SCHOENHERR RD STE 2",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131972",
            "telephone_number": "586-726-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBAUDO",
        "first_name": "RACHEL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704289816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.