Active NPI
Kara Nicole Szczomak, PA-C
- Physician Assistant
- Clinton Township, MI
National Provider Identifier
1013280262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601006308
- Practice address
- 15855 19 Mile Rd
Clinton Township, MI 48038-3504 - Phone
- (586) 263-2601
- Fax
- (586) 263-2589
- NPI assigned
- Feb 20, 2012
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601006308 | MI | Primary |
Addresses
Primary practice location
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Mailing address
38935 Ann Arbor Rd
Livonia, MI 48150-3397
Phone (734) 632-0175
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Other | MI | CAQH |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120411000868 | MI | Practitioner - Physician Assistant | 5294996617 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Academic Dermatology and Cosmetic Surgery Center PLLC
Practice addresses (Care Compare)
51189 Shelby Pkwy
Shelby Township, MI 48315-1786
Phone (586) 997-9700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
-
- Dermatology Physician
- Shelby TWP., MI
- NPI 1265645535
MI
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331769600000",
"number": "1013280262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38935 ANN ARBOR RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481503397",
"telephone_number": "734-632-0175",
"fax_number": "734-632-0182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15855 19 MILE RD",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480383504",
"telephone_number": "586-263-2601",
"fax_number": "586-263-2589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SZCZOMAK",
"first_name": "KARA",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-20",
"last_updated": "2012-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601006308",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "PENDING",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.