NPIMap

Individual provider Active NPI

Kelly K Machesky, MD

  • Family Medicine Physician
  • Shelby Township, MI
National Provider Identifier
1033168125
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301066553 Issued in MI
Practice address
13350 24 Mile Rd Ste 200
Shelby Township, MI 48315-1826
Phone
(586) 566-7100
Fax
(586) 566-8088
NPI assigned
May 8, 2006
Last updated
Apr 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301066553 MI Primary

Addresses

Primary practice location

13350 24 Mile Rd Ste 200
Shelby Township, MI 48315-1826

Mailing address

13350 24 Mile Rd Ste 200
Shelby Township, MI 48315-1826
Phone (586) 566-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100809000196 MI Practitioner - Family Practice 0042343253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Cornerstone Medical GroupGroup PAC ID 7517162761, 65 clinicians
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians

Practice addresses (Care Compare)

15055 22 Mile Rd
Suite 3
Shelby TWP, MI 48315-4401
Phone (586) 566-7100

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Cornerstone Medical Group Family Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

4260 Van Dyke Rd
Ste 102
Almont, MI 48003
Phone (810) 798-3994

43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

13350 24 Mile Rd
Ste 200
Shelby Township, MI 48315
Phone (586) 566-7100

15055 22 Mile Rd
Ste 3
Shelby Township, MI 48315
Phone (586) 566-7100

28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/
  • Direct secure messaging: kelly.machesky.2@8209.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1033168125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13350 24 MILE RD STE 200",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483151826",
            "telephone_number": "586-566-7100",
            "fax_number": "586-566-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13350 24 MILE RD STE 200",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483151826",
            "telephone_number": "586-566-7100",
            "fax_number": "586-566-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHESKY",
        "first_name": "KELLY",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301066553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.