Active NPI
Kelly Jeanne Kozlowski, DO
- Emergency Medicine Physician
- Dearborn, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 5101016832
- Practice address
- 19401 Hubbard Dr
Dearborn, MI 48126-2641 - Phone
- (313) 982-8261
- NPI assigned
- Feb 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 5101016832 | MI | Primary |
Addresses
Primary practice location
19401 Hubbard Dr
Dearborn, MI 48126-2641
Mailing address
16878 Orchard Gardens Dr
Macomb, MI 48042-1195
Phone (313) 623-4707
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Michigan State University College of Osteopathic Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3500 15 Mile Rd
Sterling Heights, MI 48310-5353
Phone (586) 977-9300
Hospital & facility affiliations
- Henry Ford Health Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101016832 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Health System | Emergency Medicine | Current | Accepting new patients |
| Henry Ford Pathology | Current | Accepting new patients | |
| Henry Ford Health System | Current | Accepting new patients |
Locations
19401 Hubbard Dr
Dearborn, MI 48126
Phone (313) 982-8100
1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
3500 15 Mile Rd
Sterling Hts, MI 48310
Phone (586) 977-9300
Interoperability endpoints
- kkozlowski19090@direct.hfhs.org
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
-
- Emergency Medicine Physician
- Detroit, MI
- NPI 1972681187
-
- Anatomic Pathology & Clinical Pathology Physician
- Detroit, MI
- NPI 1851410005
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1144356288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16878 ORCHARD GARDENS DR",
"city": "MACOMB",
"state": "MI",
"postal_code": "480421195",
"telephone_number": "313-623-4707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19401 HUBBARD DR",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262641",
"telephone_number": "313-982-8261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOZLOWSKI",
"first_name": "KELLY",
"middle_name": "JEANNE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-25",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "5101016832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.