Individual provider Active NPI

Katherine Jean Valmores Yulo, M.D.

  • Pediatrics Physician
  • Shelby Township, MI
National Provider Identifier
1073826301
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301102193 Issued in MI
Practice address
15125 22 Mile Rd
Shelby Township, MI 48315
Phone
(586) 532-0599
Fax
(586) 566-8967
NPI assigned
Jul 15, 2010
Last updated
Sep 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036124120 IL
Pediatrics Physician 208000000X 01067652A IN
Pediatrics Physician 208000000X 4301102193 MI Primary

Addresses

Primary practice location

15125 22 Mile Rd
Shelby Township, MI 48315

Mailing address

15125 22 Mile Rd
Shelby Township, MI 48315
Phone (586) 532-0599

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
I20140206001240 MI Practitioner - Pediatric Medicine 4486883725 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036124120ILMDPediatrics Physician
01067652AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJMH Medical Practice-SMHC Pediatrics CurrentSince Feb 27, 2017 Accepting new patients
SJMH Medical Practice-SMHC CurrentSince Feb 27, 2017 Accepting new patients
Shelby Pediatric Associates and Child Lung Center PC Pediatrics PastSince Sep 12, 2021 Accepting new patients
Michigan Kidney Consultants, P.C. PastSince Sep 1, 2003 Accepting new patients
Great Lakes Pediatric Cardiology PLLC PastSince May 8, 2023 Accepting new patients

Locations

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

Interoperability endpoints

  • Direct secure messaging: katherine.jean.yulo.1@7131.direct.athenahealth.com
  • Direct secure messaging: kyulo40101@direct.trinity-health.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1073826301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15125 22 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "48315",
            "telephone_number": "586-532-0599",
            "fax_number": "586-566-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15125 22 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "48315",
            "telephone_number": "586-532-0599",
            "fax_number": "586-566-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YULO",
        "first_name": "KATHERINE JEAN",
        "middle_name": "VALMORES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036124120",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01067652A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301102193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.