Jeffery A Kwiatkowski, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004928 Issued in MI

Practice address

1501 W Chisholm St
Alpena, MI 49707-1401

Phone

(800) 968-6866

Fax

(616) 532-7230

NPI assigned

Jan 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Mymichigan Medical Center Alma

  • Emergency Medicine Physician
  • Alma, MI
  • NPI 1568914422
  Medicare reassignment NPD
• Mymichigan Medical Center Alpena

  • Emergency Medicine Physician
  • Alpena, MI
  • NPI 1508332792
  Medicare reassignment NPD
• Mymichigan Medical Center West Branch

  • General Acute Care Hospital
  • West Branch, MI
  • NPI 1538566765
  Medicare reassignment NPD
• Hometown Urgent Care of Michigan, P.C.

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1790030385

  MI

  Medicare reassignment NPD
• Alpena Express Care and Family Practice, PLC

  • Family Medicine Physician
  • Alpena, MI
  • NPI 1992981559
  Medicare reassignment
• Mymichigan Medical Center Clare

  • General Practice Physician
  • Clare, MI
  • NPI 1134394026
  Medicare reassignment
• Northwestern Michigan Emergency Physicians PC

  • Emergency Medicine Physician
  • Traverse City, MI
  • NPI 1073597944
  Medicare reassignment
• Hometown Urgent Care of Michigan, P.C.

  • Clinical Medical Laboratory
  • Kalamazoo, MI
  • NPI 1891469631
  NPD
• Mymichigan Medical Center Clare

  • Emergency Medicine Physician
  • Clare, MI
  • NPI 1962888180
  NPD
• West Branch Regional Medical Center

  • Rural Acute Care Hospital
  • West Branch, MI
  • NPI 1396732103
  NPD
• Hometown Urgent Care of Michigan, PC

  • Clinical Medical Laboratory
  • Indianapolis, IN
  • NPI 1881358489
  NPD
• Thunder Bay Emergency Physicians PC

  • Emergency Medicine Physician
  • Alpena, MI
  • NPI 1174526594
  NPD (past)

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1124179627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2347",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495012347",
            "telephone_number": "800-968-6866",
            "fax_number": "616-532-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W CHISHOLM ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071401",
            "telephone_number": "800-968-6866",
            "fax_number": "616-532-7230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 N Center Ave",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497351592",
            "country_code": "US",
            "telephone_number": "989-731-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWIATKOWSKI",
        "first_name": "JEFFERY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keri Kruse
• Brian John Kruzell, LLMSW
• Sarah Elizabeth Kundinger
• Erika Kuznicki, RN
• Erin Kuznicki
• Mariah Rita Kwiatkowski
• Caren Anne Labrecque
• Mario Dante Lacerna, MD
• Larry Lacross, LLMSW
• Patricia Marie Lacross, BSN, RN

• Physician Assistant in Alpena, MI
• Providers in Alpena, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.