RACHEL DISTELRATH (FNP-BC) – Family Nurse Practitioner, NPI 1184440158

RACHEL DISTELRATH (FNP-BC) is a healthcare provider. based in Port huron, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-BC. They hold a License No. 4704292139 (MI). The NPI Number for RACHEL DISTELRATH (FNP-BC) is 1184440158

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
RACHEL DISTELRATH (FNP-BC)
NPI
1184440158
Phone
(810) 662-3505
Address
1210 10TH AVE
Enumeration Date
25 November 2024
Last Update Date
22 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8106623505
Graduation Year
2024 (2 years ago)
PAC ID
9739600149
Group Practice PAC ID
3577994490
Professional Enrollment ID
I20250228003336
Address ID
MI480603406PO1210XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

8,105 NURSE PRACTITIONER in MI

Provider Addresses for RACHEL DISTELRATH (FNP-BC)

  • 1210 10TH AVE

    PORT HURON, MI 480603406

    Phone: (810) 662-3505

    Fax: (810) 662-3479

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $59.

Total Amount is formed as General ($59) + Research ($0) + Ownership ($0) = $59.

Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Axsome Therapeutics, Inc. ($21).

Total Amount

$59

General + Research + Ownership

Payments

3

Total payment records

General Amount

$59

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-16

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250228003336INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48060)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3577994490View full group profile
NameSpecialtyState
Nurse PractitionerMI
Internal MedicineMI

Reviews

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Frequently asked questions

How do I look up RACHEL DISTELRATH (FNP-BC) by NPI?
Use NPI 1184440158 when you need to reference RACHEL DISTELRATH (FNP-BC) in forms, claims, or directories.
Does this profile mean RACHEL DISTELRATH (FNP-BC) is currently active?
Yes — RACHEL DISTELRATH (FNP-BC) appears active in the national provider directory.
Can you summarize RACHEL DISTELRATH (FNP-BC)'s specialty in plain language?
Clinically, the directory lists RACHEL DISTELRATH (FNP-BC) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place RACHEL DISTELRATH (FNP-BC)?
The snapshot lists Port Huron, Michigan for RACHEL DISTELRATH (FNP-BC); download NPPES for the complete set.
What if Port Huron, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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