NPIMap

Individual provider Active NPI

Rebecca Dawn Martinez, PA-C

  • Physician Assistant
  • Livonia, MI
National Provider Identifier
1962600189
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1075283 Issued in MI
Practice address
20317 Farmington Rd
Livonia, MI 48152-1411
Phone
(248) 615-0777
Fax
(248) 615-0779
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1075283 MI Primary

Addresses

Primary practice location

20317 Farmington Rd
Livonia, MI 48152-1411

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other names 1

  • Rebecca Dawn Hilss Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rmartinez96377@direct.beaumont.edu

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
I20071101000085 MI Practitioner - Physician Assistant 8628163789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

20317 Farmington Rd
Livonia, MI 48152-1411
Phone (248) 615-0777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1075283MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Botsford General Hospital CurrentSince Jun 25, 2007 Accepting new patients
Oakwood Ambulatory LLC CurrentSince Dec 1, 2018 Accepting new patients
Botsford General Hospital Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

28100 Grand River Ave
Ste 206
Farmington Hills, MI 48336
Phone (248) 471-1549

20317 Farmington Rd
Livonia, MI 48152
Phone (248) 615-0777

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Interoperability endpoints

  • Direct secure messaging: rmartinez96377@direct.beaumont.edu

Organizations & group practices 3

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 11

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1962600189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20317 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521411",
            "telephone_number": "248-615-0777",
            "fax_number": "248-615-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "REBECCA",
        "middle_name": "DAWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "1075283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmartinez96377@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "20317 Farmington Rd",
            "city": "Livonia",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481521411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "HILSS",
            "middle_name": "DAWN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.