Individual provider Active NPI

Elizabeth Kowynia, PA-C

  • Physician Assistant
  • Southfield, MI
National Provider Identifier
1033855861
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
29405 Greenfield Rd
Southfield, MI 48076-2226
Phone
(248) 983-5330
Fax
(248) 327-7482
NPI assigned
May 5, 2022
Last updated
Feb 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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 Primary

Addresses

Primary practice location

29405 Greenfield Rd
Southfield, MI 48076-2226

Mailing address

29405 Greenfield Rd
Southfield, MI 48076-2226
Phone (248) 983-5330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20230817000820 IL Practitioner - Physician Assistant 5698155034 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

121 W N Ave
Chicago, IL 60610-1315
Phone (312) 643-5606

2077 N Clybourn Ave
Chicago, IL 60614-4003
Phone (773) 886-1500

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

5228 N Northwest Hwy
Chicago, IL 60630-4620
Phone (773) 770-4707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnow Urgent Care, PC CurrentSince Jul 8, 2024 Accepting new patients

Locations

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

230 N Genesee St
Utica, NY 13502
Phone (315) 275-3214

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

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1033855861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29405 GREENFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762226",
            "telephone_number": "248-983-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29405 GREENFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762226",
            "telephone_number": "248-983-5330",
            "fax_number": "248-327-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWYNIA",
        "first_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.