Kelsa Kazyak, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4351051064 Issued in MI

Practice address

3535 W 13 Mile Rd Ste 329
Royal Oak, MI 48073-6770

Phone

(248) 551-0845

NPI assigned

Mar 30, 2022

Reactivated

Jun 1, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kelsa.kazyak.1@14250.direct.athenahealth.com
• Direct secure messaging: kelsa.kazyak@beaumont.org

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.

• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  NPD (past)

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1144960048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD STE 329",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-551-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZYAK",
        "first_name": "KELSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "deactivation_date": "2023-05-15",
        "reactivation_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4351051064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelsa.kazyak@beaumont.org",
            "affiliation": "Y",
            "affiliationName": "WILLIAM BEAUMONT HOSPITAL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3601 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rheanna L Kays, PHARMD
• Demetra Christina Kazanis, DDS
• Noora Kazanji, D.O.
• Chris Kazmierczak
• Michelle Kazmierski
• Miriam L Keaton, NP
• Kunal Kedar
• Daniel T. Keena, M.D.
• Megan Keersmaekers
• Richard David Keidan, MD

• Obstetrics & Gynecology Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.