Individual provider Active NPI

Heather Ashlyn Kowalski

  • Family Nurse Practitioner
  • Royal Oak, MI
National Provider Identifier
1124709548
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704348924 Issued in MI
Practice address
3535 W 13 Mile Rd Ste 140
Royal Oak, MI 48073-6770
Phone
(248) 551-3000
NPI assigned
Jul 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704348924 MI Primary

Addresses

Primary practice location

3535 W 13 Mile Rd Ste 140
Royal Oak, MI 48073-6770

Mailing address

3535 W 13 Mile Rd Ste 140
Royal Oak, MI 48073-6770
Phone (248) 551-3000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240313003526 MI Practitioner - Nurse Practitioner 4082069349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William Beaumont HospitalGroup PAC ID 9335051093, 20 clinicians

Practice addresses (Care Compare)

26001 Jefferson Ave
Saint Clair Shores, MI 48081-2309
Phone (586) 779-7000

3535 W 13 Mile Rd
Royal Oak, MI 48073-6770

3535 W 13 Mile Rd LL
Cor HLTH Univ Hosp
Royal Oak, MI 48073-6770
Phone (248) 551-3000

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
William Beaumont Hospital Current Accepting new patients
William Beaumont Hospital CurrentSince Feb 7, 2024 Accepting new patients
William Beaumont Hospital CurrentSince Feb 7, 2024 Accepting new patients

Locations

3535 W 13 Mile Rd
Ste 140
Royal Oak, MI 48073
Phone (248) 551-3000

26001 Jefferson Ave
Saint Clair Shores, MI 48081
Phone (586) 779-7000

26901 Beaumont Blvd
#3D
Southfield, MI 48033

Interoperability endpoints

  • Direct secure messaging: hkowalski1242309@epic00.shdirect.org

Organizations & group practices 12

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.

Hospital & facility affiliations 3

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": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1124709548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD STE 140",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-551-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD STE 140",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-551-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "HEATHER",
        "middle_name": "ASHLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704348924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.