Individual provider Active NPI

Kristin Hofstad, PA

  • Physician Assistant
  • Mount Clemens, MI
National Provider Identifier
1013646652
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010949 Issued in MI
Practice address
1000 Harrington St
Mount Clemens, MI 48043-2920
Phone
(586) 493-8000
Fax
(586) 493-8799
NPI assigned
Jun 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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 5601010949 MI Primary

Addresses

Primary practice location

1000 Harrington St
Mount Clemens, MI 48043-2920

Mailing address

1000 Harrington St
Mount Clemens, MI 48043-2920
Phone (586) 493-8000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220615002209 MI Practitioner - Physician Assistant 0345629788 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren MacombGroup PAC ID 8921912791, 131 clinicians
McLaren Hospital GroupGroup PAC ID 2365968351, 366 clinicians

Practice addresses (Care Compare)

1000 Harrington St
Mount Clemens, MI 48043-2920
Phone (810) 493-8000

37399 Garfield Rd
Clinton Township, MI 48036-3672

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Hospital Group CurrentSince Nov 11, 2025 Accepting new patients
McLaren Macomb CurrentSince Jun 14, 2022 Accepting new patients

Locations

37399 Garfield Rd
Ste 203
Clinton Twp, MI 48036
Phone (586) 228-2911

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

Organizations & group practices 2

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 2

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": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1013646652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-8000",
            "fax_number": "586-493-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-8000",
            "fax_number": "586-493-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFSTAD",
        "first_name": "KRISTIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.