NPIMap

Individual provider Active NPI

John Joseph Kalenkiewicz, M.D.

  • Internal Medicine Physician
  • Monroe, MI
National Provider Identifier
1093706640
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MI4301050330 Issued in MI
Practice address
730 North Macomb Street
Suite 400
Monroe, MI 48162-2904
Phone
(734) 242-6499
Fax
(734) 242-8992
NPI assigned
Nov 2, 2005
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MI4301050330 MI Primary

Addresses

Primary practice location

730 North Macomb Street
Suite 400
Monroe, MI 48162-2904

Mailing address

730 North Macomb Street
Suite 400
Monroe, MI 48162-2904
Phone (734) 242-6499

Other identifiers 1

IdentifierTypeStateIssuer
4301050330OtherMIMD LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkalenkiewicz25935@epicdirect.promedica.org

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
I20080501000159 MI Practitioner - Internal Medicine 2668376179 Practice locations: Monroe, MI

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Michigan Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

730 N Macomb St
Monroe, MI 48162-2904
Phone (734) 242-6499

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MI4301050330MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 1

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 6

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1093706640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 NORTH MACOMB STREET",
            "address_2": "SUITE 400",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481622904",
            "telephone_number": "734-242-6499",
            "fax_number": "734-242-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 NORTH MACOMB STREET",
            "address_2": "SUITE 400",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481622904",
            "telephone_number": "734-242-6499",
            "fax_number": "734-242-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALENKIEWICZ",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "MI4301050330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "4301050330",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkalenkiewicz25935@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "730 NORTH MACOMB STREET",
            "address_2": "SUITE 400",
            "city": "MONROE",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481622904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.