Individual provider Active NPI

Kevin C Caith, PA

  • Physician Assistant
  • Ypsilanti, MI
National Provider Identifier
1164730412
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008033 Issued in MI
Practice address
5315 Elliott Dr
Suite 301
Ypsilanti, MI 48197
Phone
(734) 572-4500
Fax
(734) 572-4503
NPI assigned
Sep 21, 2010
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008033 MI Primary

Addresses

Primary practice location

5315 Elliott Dr
Suite 301
Ypsilanti, MI 48197

Mailing address

24 Frank Lloyd Wright Dr
Lobby J2000
Ann Arbor, MI 48105
Phone (734) 572-4500

Other identifiers 3

IdentifierTypeStateIssuer
5315090475OtherMIMICHIGAN CONTROLLED SUBSTANCE LICENSE
1093370OtherMINCCPA CERTIFICATION
5601008033OtherMIMICHIGAN PA LICENSE

Other names 1

  • Kevin C Smith Former name

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
I20180314002505 MI Practitioner - Physician Assistant 4284822115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677

1600 S Canton Ctr Rd
Canton, MI 48188-1992

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

5315 Elliott Dr
Ypsilanti, MI 48197-8634

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation CurrentSince Apr 1, 2019 Accepting new patients
Iha Health Service Corporation CurrentSince Apr 1, 2019 Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

14650 E Old US Highway 12
Ste 101
Chelsea, MI 48118
Phone (734) 475-3979

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5315 Elliott Dr
Ste 301
Ypsilanti, MI 48197
Phone (734) 572-4500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1164730412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "address_2": "LOBBY J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-572-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 ELLIOTT DR",
            "address_2": "SUITE 301",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48197",
            "telephone_number": "734-572-4500",
            "fax_number": "734-572-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAITH",
        "first_name": "KEVIN",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN CONTROLLED SUBSTANCE LICENSE",
            "identifier": "5315090475",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA CERTIFICATION",
            "identifier": "1093370",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN PA LICENSE",
            "identifier": "5601008033",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEVIN",
            "last_name": "SMITH",
            "middle_name": "C",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.