Individual provider Active NPI

Katherine Foley Cuello la O, DO

  • Surgery Physician
  • Clinton Township, MI
National Provider Identifier
1164786570
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5315204340 Issued in MI
Practice address
21510 Harrington St
Clinton Township, MI 48036-2377
Phone
(586) 228-3600
NPI assigned
Jun 29, 2012
Last updated
Jul 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5315204340 MI Primary

Addresses

Primary practice location

21510 Harrington St
Clinton Township, MI 48036-2377

Mailing address

21510 Harrington St Ste 102
Clinton TWP, MI 48036-2378
Phone (586) 228-3800

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190516000815 MI Practitioner - Vascular SurgeryPractitioner - General Surgery 1951671957 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Macomb Surgical Associates,P.C.Group PAC ID 7719994052, 4 clinicians
McLaren MacombGroup PAC ID 8921912791, 131 clinicians

Practice addresses (Care Compare)

21510 Harrington St
Suite 102
Clinton TWP, MI 48036-2378
Phone (586) 228-3800

36500 S Gratiot Ave
102 Multispecialties
Clinton Township, MI 48035-1772
Phone (586) 790-9003

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)11
Removal of tissue47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5315204340MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Macomb Surgical Associates,P.C. Multi-Specialty CurrentSince Jul 1, 2019 Accepting new patients
McLaren Port Huron Multi-Specialty Current Accepting new patients
McLaren Macomb Multi-Specialty CurrentSince May 1, 2019 Accepting new patients
McLaren Port Huron Multi-Specialty CurrentSince Mar 2, 2022 Accepting new patients
McLaren Macomb Past Accepting new patients

Locations

21510 Harrington St
Ste 102
Clinton Twp, MI 48036
Phone (586) 228-3800

36500 S Gratiot Ave
Ste 102
Clinton Twp, MI 48035
Phone (586) 790-9003

37399 Garfield Rd
Ste 203
Clinton Twp, MI 48036
Phone (586) 228-2911

37400 Garfield Rd
Ste 120
Clinton Twp, MI 48036
Phone (586) 228-3800

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

1107 Stone St
Ste 1
Port Huron, MI 48060
Phone (810) 982-8300

1163 S Carney Dr
Saint Clair, MI 48079
Phone (810) 561-8450

Interoperability endpoints

  • Direct secure messaging: kfoley602897@direct.hfhs.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
McLaren Port HuronPort Huron, MI, CCN 230216 Hospital Corporate Director Mar 24, 2026
McLaren Port HuronPort Huron, MI, CCN 23S216 Hospital Corporate Director Mar 24, 2026

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 5

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": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1164786570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21510 HARRINGTON ST STE 102",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480362378",
            "telephone_number": "586-228-3800",
            "fax_number": "586-228-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21510 HARRINGTON ST",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480362377",
            "telephone_number": "586-228-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUELLO LA O",
        "first_name": "KATHERINE",
        "middle_name": "FOLEY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5315204340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.