NPIMap

Individual provider Active NPI

Jessica Marie Kaniowski, M.D.

  • Diagnostic Radiology Physician
  • Southfield, MI
National Provider Identifier
1073717682
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301090461 Issued in MI
Practice address
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone
(248) 849-3000
NPI assigned
Jun 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301090461 MI Primary

Addresses

Primary practice location

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Mailing address

118 S Georgetown SQ
Royal Oak, MI 48067-3204
Phone (248) 543-6559

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
I20120709000695 MI Practitioner - Diagnostic Radiology 5890950224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DRS Harris Birkhill Wang Songe and Assoc PCGroup PAC ID 3779495338, 63 clinicians

Practice addresses (Care Compare)

10000 Telegraph Rd
Taylor, MI 48180-3330
Phone (313) 295-5142

18100 Oakwood Blvd
Suite 200
Dearborn, MI 48124-4085
Phone (313) 593-7301

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 593-7301

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-6005

25045 Ford Rd
Suite 100
Dearborn, MI 48128-1088
Phone (313) 359-7650

33101 Annapolis St
Wayne, MI 48184-2405
Phone (313) 359-7600

33155 Annapolis St
Wayne, MI 48184-2405
Phone (734) 467-4000

5450 Fort St
Trenton, MI 48183-4601
Phone (734) 671-3877

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
53.55 of 100Reported as group
Quality
30
Improvement activities
40
Cost
57.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301090461MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Harris Birkhill Wang Songe & Assoc PC Diagnostic Radiology CurrentSince Jul 1, 2013 Accepting new patients
Oakwood Healthcare Inc Past Accepting new patients

Locations

18100 Oakwood Blvd
Ste 200
Dearborn, MI 48124
Phone (313) 438-7715

840 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 359-7600

718 N Macomb St
Monroe, MI 48162
Phone (734) 212-3097

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073717682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 S GEORGETOWN SQ",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673204",
            "telephone_number": "248-543-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANIOWSKI",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301090461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.