Walter Gregory Korytowsky, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301040841 Issued in MI

Practice address

3333 Spring Arbor Rd
Suite 400
Jackson, MI 49203-8605

Phone

(517) 783-6435

Fax

(517) 783-6347

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• None None None Other name

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

Dermatology

Education

University of Michigan Medical School, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Skin Surgery CenterGroup PAC ID 2668467838, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hillsdale Hospital Hospital, Hillsdale, MI, CCN 230037

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wkorytowsky462950@direct.hfhs.org

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 & Skin Surgery Center

  • Specialist
  • Battle Creek, MI
  • NPI 1083649628
  Medicare reassignment Care Compare group NPD

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

• Hillsdale Community Health Center

  • General Acute Care Hospital
  • Hillsdale, MI
  • NPI 1730115940
  Care Compare affiliation

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1043325632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 SPRING ARBOR RD",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492038605",
            "telephone_number": "517-783-6435",
            "fax_number": "517-783-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SPRING ARBOR RD",
            "address_2": "SUITE 400",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492038605",
            "telephone_number": "517-783-6435",
            "fax_number": "517-783-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORYTOWSKY",
        "first_name": "WALTER",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301040841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "0703800982",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE/CARE NETWORK",
            "identifier": "P58275",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP MICHIGAN",
            "identifier": "0320049",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1570689",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "4301040841",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NONE",
            "last_name": "NONE",
            "middle_name": "NONE",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Aram Koltookian, DO
• Angela D Kono, LPC
• Patricia Lynn Koprivica, CRNA
• Laura Marie Kopulos, CRNA
• Samuel T Korican, PA-C
• Aron O'Brien Koszegi, M.A., L.L.P.
• Risten Koszegi
• Lily Kovach
• Ashley Rose Kowynia
• April Kral, OT

• Dermatology Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.