NPIMap

Individual provider Active NPI

Prashant Sudhir Kelkar, D.O.

  • Neurological Surgery Physician
  • Southfield, MI
National Provider Identifier
1053536755
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
5101017275 Issued in MI
Practice address
22250 Providence Dr Ste 601
Southfield, MI 48075-6214
Phone
(248) 569-7745
Fax
(248) 569-4539
NPI assigned
Apr 16, 2007
Last updated
Jan 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 5101017275 MI Primary

Addresses

Primary practice location

22250 Providence Dr Ste 601
Southfield, MI 48075-6214

Mailing address

22250 Providence Dr
Ste 601
Southfield, MI 48075-6214
Phone (630) 484-1738

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
I20150507000190 MI Practitioner - Neurosurgery 2062637044 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Mid West Medical College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Practice addresses (Care Compare)

26850 Providence Pkwy
Novi, MI 48374-1213
Phone (248) 465-4500

641 W 9 Mile Rd D
Ferndale, MI 48220-1779
Phone (248) 951-9080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.34 of 100Reported as group
Quality
82
Improvement activities
40
Cost
86.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion176
Laminectomy or laminotomy (partial removal of spine bones)48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101017275MIMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Providence Hospital CurrentSince Jan 1, 2025 Accepting new patients
Michigan Spine and Brain Surgeons, PLLC Neurological Surgery CurrentSince Jul 20, 2015 Accepting new patients
Henry Ford Health Providence Hospital CurrentSince Jan 1, 2025 Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients

Locations

26850 Providence Pkwy
Novi, MI 48374
Phone (248) 380-3550

26850 Providence Pkwy
Ste 215
Novi, MI 48374
Phone (248) 569-7745

26850 Providence Pkwy
Ste 240
Novi, MI 48374
Phone (248) 440-2162

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

22250 Providence Dr
Ste 601
Southfield, MI 48075
Phone (248) 569-4885

11900 E 12 Mile Rd
Ste 206
Warren, MI 48093
Phone (313) 558-5010

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBEFBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/JBEFBA/Endpoint/JBEFBA
  • Direct secure messaging: pkelkar1134343@direct.hfhs.org
  • Direct secure messaging: prashant.kelkar@msbs.eclinicaldirectplus.com

Organizations & group practices 5

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1053536755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "STE 601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756214",
            "telephone_number": "630-484-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756214",
            "telephone_number": "248-569-7745",
            "fax_number": "248-569-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELKAR",
        "first_name": "PRASHANT",
        "middle_name": "SUDHIR",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "5101017275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.