NPIMap

Individual provider Active NPI

Carole L Kowalczyk, MD

  • Reproductive Endocrinology Physician
  • Warren, MI
National Provider Identifier
1053472027
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
4301054864 Issued in MI
Practice address
4700 E. 13 Mile Road
Suite 200
Warren, MI 48092
Phone
(586) 576-0431
Fax
(586) 576-0924
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X CK 054864 MI
Reproductive Endocrinology Physician 207VE0102X 4301054864 MI Primary

Addresses

Primary practice location

4700 E. 13 Mile Road
Suite 200
Warren, MI 48092

Mailing address

4700 E. 13 Mile Road
Suite 200
Warren, MI 48092
Phone (586) 576-0431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301054864MIMDReproductive Endocrinology Physician
CK 054864MIMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Center Ivf, PLLC Past Accepting new patients
Michigan Center for Fertility and Womens Health, PLC Reproductive Endocrinology PastSince Jan 28, 2003 Accepting new patients
University Physician Group Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ckowalczyk1135155@direct.hfhs.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1053472027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 E. 13 MILE ROAD",
            "address_2": "SUITE 200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48092",
            "telephone_number": "586-576-0431",
            "fax_number": "586-576-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 E. 13 MILE ROAD",
            "address_2": "SUITE 200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48092",
            "telephone_number": "586-576-0431",
            "fax_number": "586-576-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALCZYK",
        "first_name": "CAROLE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MI",
            "license": "CK 054864",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "MI",
            "license": "4301054864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.