Active NPI
Rachel Tibaudo, FNP
- Family Nurse Practitioner
- Sterling Heights, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704289816
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silver Pine Medical Group PLC | Current | Accepting new patients | |
| Bayside Family Medicine Chesterfield PC | Past | 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
- rfillmore466058@direct.hfhs.org
- 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.
-
- Family Medicine Physician
- Sterling Heights, MI
- NPI 1639105695
-
- Family Medicine Physician
- Chesterfield, MI
- NPI 1790018315
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.