Individual provider Active NPI

Andrew John Ketner, D.O.

  • Orthopaedic Surgery Physician
  • Waterford, MI
National Provider Identifier
1043574874
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
5101019855 Issued in MI
Practice address
4000 Highland Rd Ste 101
Waterford, MI 48328-2163
Phone
(248) 270-5622
Fax
(248) 856-2474
NPI assigned
Jun 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5101019855 MI Primary

Addresses

Primary practice location

4000 Highland Rd Ste 101
Waterford, MI 48328-2163

Mailing address

4000 Highland Rd Ste 101
Waterford, MI 48328-2163
Phone (248) 270-5622

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180710001532 MI Practitioner - Orthopedic Surgery 8224271648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Michigan State University College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ketner Orthopedics PLLCGroup PAC ID 5991293599, 2 clinicians

Practice addresses (Care Compare)

5624 Highland Rd
Waterford, MI 48327-1926
Phone (248) 515-1859

Hospital & facility affiliations

  • Parc Home Care Home health agency, Farmington Hills, MI, CCN 239272
  • Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277
  • Rehabilitation Institute of Michigan Inpatient rehabilitation facility, Detroit, MI, CCN 233027

Merit-based Incentive Payment System (MIPS)

Final score
90.26 of 100Reported as group
Quality
64.16
Promoting interoperability
100
Improvement activities
40
Cost
73.79

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019855MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan CurrentSince Jul 2, 2018 Accepting new patients
Dana M Busch DO PLLC CurrentSince Aug 30, 2025 Accepting new patients
Ketner Orthopedics PLLC CurrentSince Aug 30, 2025 Accepting new patients

Locations

1 William Carls Dr
Ste 230
Commerce Twp, MI 48382
Phone (248) 360-4507

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

311 Mack Ave
Fl 5
Detroit, MI 48201
Phone (313) 832-0500

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

4000 Highland Rd
Ste 101
Waterford, MI 48328
Phone (248) 270-5622

5624 Highland Rd
Waterford, MI 48327
Phone (248) 674-4110

Interoperability endpoints

  • Direct secure messaging: andrewketner@ketner.directglo.com

Organizations & group practices 3

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 3

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1043574874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HIGHLAND RD STE 101",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282163",
            "telephone_number": "248-270-5622",
            "fax_number": "248-856-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HIGHLAND RD STE 101",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282163",
            "telephone_number": "248-270-5622",
            "fax_number": "248-856-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETNER",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101019855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.