Individual provider Active NPI

Kristen Elizabeth Cares, M.D.

  • Pediatric Gastroenterology Physician
  • Detroit, MI
National Provider Identifier
1063641637
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
4301094683 Issued in MI
Practice address
3901 Beaubien St
Detroit, MI 48201-2119
Phone
(313) 745-5427
NPI assigned
Jul 4, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301094683 MI
Pediatric Gastroenterology Physician 2080P0206X 4301094683 MI Primary

Addresses

Primary practice location

3901 Beaubien St
Detroit, MI 48201-2119

Mailing address

4201 St. Antoine Uhc 5D Mailbox 226
University Pediatricians
Detroit, MI 48201-2153
Phone (313) 745-4405

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
I20150112002069 MI Practitioner - Pediatric Medicine 0840514220 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301094683MIMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians Pediatrics CurrentSince Dec 1, 2014 Accepting new patients
University Pediatricians Pediatrics CurrentSince Dec 1, 2014 Accepting new patients

Locations

3901 Beaubien St
Fl 2
Detroit, MI 48201
Phone (313) 745-0659

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

Organizations & group practices 2

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": "1246665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1063641637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 ST. ANTOINE UHC 5D MAILBOX 226",
            "address_2": "UNIVERSITY PEDIATRICIANS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4405",
            "fax_number": "313-966-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARES",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-04",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301094683",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MI",
            "license": "4301094683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.