Glenn Evan Kershen, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

GK075761 Issued in MI

Practice address

1117 S Washington Ave
Saginaw, MI 48601-2558

Phone

(989) 791-4020

Fax

(989) 921-8765

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Electronic endpoints 1

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

Specialty

Urology

Education

State University of New York at Buffalo School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-City Urology Associates PCGroup PAC ID 8729081963, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Care Team Home health agency, Saginaw, MI, CCN 239226
• McLaren Home Health Home health agency, Bay City, MI, CCN 237165
• McLaren Bay Region Hospital, Bay City, MI, CCN 230041
• Mymichigan Medical Center Saginaw Hospital, Saginaw, MI, CCN 230077
• Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
• Covenant Medical Center Hospital, Saginaw, MI, CCN 230070
• Mymichigan Medical Center West Branch Hospital, West Branch, MI, CCN 230095

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Tri City Urology Associates PC

  • Urology Physician
  • Saginaw, MI
  • NPI 1366463101
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Covenant Medical Center, Inc.

  • General Acute Care Hospital
  • Saginaw, MI
  • NPI 1588656946
  Care Compare affiliation
• Great Lakes Home Health Care Agency, LLC

  • Home Health Agency
  • Saginaw, MI
  • NPI 1497069173
  Care Compare affiliation
• McLaren Bay Region

  • General Acute Care Hospital
  • Bay City, MI
  • NPI 1528031226
  Care Compare affiliation
• McLaren Health Management Group

  • Home Health Agency
  • Bay City, MI
  • NPI 1932143682
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490

  Hospital

  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1376973149
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1902841414
  Care Compare affiliation
• Mymichigan Medical Center Saginaw

  • General Acute Care Hospital
  • Saginaw, MI
  • NPI 1871507509
  Care Compare affiliation
• Mymichigan Medical Center West Branch

  • Family Medicine Physician
  • West Branch, MI
  • NPI 1518418292

  Hospital

  Care Compare affiliation
• Mymichigan Medical Center West Branch

  • General Acute Care Hospital
  • West Branch, MI
  • NPI 1538566765
  Care Compare affiliation

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1013900190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 S WASHINGTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486012558",
            "telephone_number": "989-791-4020",
            "fax_number": "989-921-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 S WASHINGTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486012558",
            "telephone_number": "989-791-4020",
            "fax_number": "989-921-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHEN",
        "first_name": "GLENN",
        "middle_name": "EVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "GK075761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI CARE",
            "identifier": "H11966",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340020605",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS",
            "identifier": "0987964",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "340G310500",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7792123",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4433790",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "helen@tricityuro.com",
            "affiliation": "N",
            "address_1": "1117 S Washington Ave",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486012558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Kerr
• Mackenzie Kerr
• Melissa Kerr, PHARM D
• Heather Kersey
• Kelsey Kershaw, MD
• Lauren Kershnar, M.D.
• Kevin B. Robinson, MD, PC
• Kevin Roy MD
• Kevin S. Bone, D.D.S., PLC
• Rachel Keyes

• Urology Physician in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.
• 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.

Verify at the official NPI Registry.