Individual provider Active NPI

Natalie Renee Kontos, DO

  • Pediatrics Physician
  • Detroit, MI
National Provider Identifier
1053571885
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101017823 Issued in MI
Practice address
22201 Moross Rd
Professional Building 2, Suite 70
Detroit, MI 48236-2169
Phone
(313) 343-4279
Fax
(313) 343-7937
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5101017823 MI Primary

Addresses

Primary practice location

22201 Moross Rd
Professional Building 2, Suite 70
Detroit, MI 48236-2169

Mailing address

22201 Moross Rd
Professional Building 2, Suite 70
Detroit, MI 48236-2169
Phone (313) 343-4279

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
I20111020000348 MI Practitioner - Pediatric Medicine 1355513193 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101017823MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Feb 3, 2017 Accepting new patients
Henry Ford Health St. John Hospital Pediatrics CurrentSince Feb 3, 2017 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
St. John Hospital Past Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22201 Moross Rd
Ste 270
Grosse Pointe, MI 48236
Phone (313) 343-3481

22201 Moross Rd
Ste 70
Grosse Pointe, MI 48236
Phone (313) 343-3700

17900 23 Mile Rd
Ste 101
Macomb, MI 48044
Phone (586) 868-9010

1135 W University Dr
Ste 355
Rochester Hills, MI 48307
Phone (248) 680-8060

Interoperability endpoints

  • Direct secure messaging: nkontos1135063@direct.hfhs.org

Organizations & group practices 4

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1053571885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD",
            "address_2": "PROFESSIONAL BUILDING 2, SUITE 70",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362169",
            "telephone_number": "313-343-4279",
            "fax_number": "313-343-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD",
            "address_2": "PROFESSIONAL BUILDING 2, SUITE 70",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362169",
            "telephone_number": "313-343-4279",
            "fax_number": "313-343-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONTOS",
        "first_name": "NATALIE",
        "middle_name": "RENEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101017823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.