ANDREA RAE BOTTERILL (PA) – Physician Assistant, NPI 1356343370
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,066 PHYSICIAN ASSISTANT in MI
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Provider Addresses for ANDREA RAE BOTTERILL (PA)
Mott Children's Hospital and Von Voigtlander Women's Hospital, 1500, East Medical Center Drive, Ann Arbor, Washtenaw County, Michigan, 48109, United States
2ND FLOOR TAUBMAN CENTER RECP C
ANN ARBOR, MI 48109
Phone: (734) 936-5780
Type: Location
South State Street, Ann Arbor, Washtenaw County, Michigan, 48108-1774, United States
700 KMS PLACE
ANN ARBOR, MI 48108
Phone: (734) 936-2047
Type: Mailing
26901 BEAUMONT BLVD STE 3D
SOUTHFIELD, MI 480333849
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2006-03-07
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060307000064 | I | Physician Assistant | MI | TBD |
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.
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 48109)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Hematology/Oncology, Internal Medicine | MI | |
| P S Y C H I A T R Y | MI | |
| - | MI | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | MI | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI |
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