Kelly Mason, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101016328 Issued in MI

Practice address

1701 Baldwin Ave Ste 102
Pontiac, MI 48340-1168

Phone

(248) 334-4962

Fax

(810) 733-1632

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.mason.p1@direct.oihn.nextgenshare.com
• FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4

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.

• Henry Ford Health Genesys Hospital

  • Podiatrist
  • Flint, MI
  • NPI 1528283033
  Medicare reassignment NPD
• Oakland Integrated Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Pontiac, MI
  • NPI 1316214299
  Medicare reassignment NPD
• Ascension Genesys Hospital

  • Skilled Nursing Facility
  • Grand Blanc, MI
  • NPI 1093125312
  NPD
• Henry Ford Health Genesys Hospital

  • Family Medicine Physician
  • Burton, MI
  • NPI 1740219526
  NPD
• Oakland Integrated Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Pontiac, MI
  • NPI 1457711202
  NPD
• Oakland Integrated Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Pontiac, MI
  • NPI 1740099464
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1003848979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 BALDWIN AVE STE 102",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483401168",
            "telephone_number": "248-334-4962",
            "fax_number": "810-733-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101016328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rashell Martinez-Esparra
• Solomon Marve
• Bashar Maskoni, M.D., M.B.A
• Susan Mason-Hollis, M.A.T., LMSW
• Jeffrey Alan Mason, DO
• Robert Mason, CPHT
• Adeel Masood, M.D.
• Darlene R Massey
• Usman G Master, MD
• Phillip J. Masterson, M.D.

• Family Medicine Physician in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.

Verify at the official NPI Registry.