Paul Walter Kenzie, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002510 Issued in MI

Practice address

108 N Main St
Plymouth, MI 48170-1236

Phone

(734) 453-8450

Fax

(734) 453-6347

NPI assigned

Nov 28, 2006

Sex

Male

Sole proprietor

Yes

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Paul Kenzie, O.D., P.C.

  • Durable Medical Equipment & Medical Supplies
  • Plymouth, MI
  • NPI 1760523336
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144396227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N MAIN ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701236",
            "telephone_number": "734-453-8450",
            "fax_number": "734-453-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N MAIN ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701236",
            "telephone_number": "734-453-8450",
            "fax_number": "734-453-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENZIE",
        "first_name": "PAUL",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Kennedy
• Raymond Kennedy
• John Robert Kenner, MSW
• Sheridan Kent, DC
• Jessica A Kenyon, OTR/L
• Emily Kerkhof
• Rolene Kerr
• Joelen Elizabeth Kersten, LLMSW, CAADC
• Amanda Rose Kertesz, MA, BCBA, LBA
• Kevin Rose PLLC

• Optometrist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.