Individual provider Active NPI

Vincent James Krolikowski, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Pontiac, MI
National Provider Identifier
1164800843
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704272184 Issued in MI
Practice address
44555 Woodward Ave
Ste. 302
Pontiac, MI 48341-5031
Phone
(248) 858-3949
NPI assigned
May 13, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704272184 MI Primary

Addresses

Primary practice location

44555 Woodward Ave
Ste. 302
Pontiac, MI 48341-5031

Mailing address

44555 Woodward Ave
Ste. 302
Pontiac, MI 48341-5031
Phone (248) 858-3949

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
I20150619000780 MI Practitioner - Nurse Practitioner 4880905637 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wayne State University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704272184MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wa Foote Memorial Hospital, Inc Nurse Practitioner Current Accepting new patients
Henry Ford Health System CurrentSince May 1, 2017 Accepting new patients
Henry Ford Health System Nurse Practitioner CurrentSince May 1, 2017 Accepting new patients
W.a. Foote Memorial Hospital, Inc Nurse Practitioner CurrentSince Dec 31, 2018 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Dec 31, 2018 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1201 E Michigan Ave
Ste 200
Jackson, MI 49201
Phone (517) 204-4841

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Interoperability endpoints

  • Direct secure messaging: vkrolikowski385035@direct.hfhs.org

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1164800843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE",
            "address_2": "STE. 302",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415031",
            "telephone_number": "248-858-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE",
            "address_2": "STE. 302",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415031",
            "telephone_number": "248-858-3949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLIKOWSKI",
        "first_name": "VINCENT",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-13",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704272184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.