Kristen Elizabeth Kavanagh, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101015629 Issued in MI

Practice address

51221 Schoenherr Rd Ste 201
Shelby TWP, MI 48315-2718

Phone

(586) 323-4450

Fax

(586) 323-4448

NPI assigned

Jun 5, 2006

Last updated

Mar 5, 2021By the provider in NPPES

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

Other identifiers 1

Other names 1

• Kristen Elizabeth West Former name

Electronic endpoints 2

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

Specialty

Family Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Henry Ford Physician PartnersGroup PAC ID 8921482605, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Home Health Care Home health agency, Detroit, MI, CCN 237087
• Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Henry Ford Physician Partners

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1427703602

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Alliance Health Professionals, PLLC

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1841615648
  Medicare reassignment NPD
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Macomb Family Medicine

  • Family Medicine Physician
  • Clinton TWP, MI
  • NPI 1134265986
  Medicare reassignment NPD
• Henry Ford Macomb Ancillary Services

  • Clinical Medical Laboratory
  • Mount Clemens, MI
  • NPI 1669864708
  NPD
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  NPD
• Henry Ford Physician Partners

  dba Henry Ford Physician Partners - PCS

  • Cardiovascular Disease Physician
  • Dearborn, MI
  • NPI 1366219651
  NPD
• Internal Medicine Associates of Mt. Clemens, PC

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1306842190
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Health System

  dba Henry Ford Home Health Care

  • Home Health Agency
  • Detroit, MI
  • NPI 1932162096
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735
  Care Compare affiliation
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1174562482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51221 SCHOENHERR RD STE 201",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483152718",
            "telephone_number": "586-323-4450",
            "fax_number": "586-323-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51221 SCHOENHERR RD STE 201",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483152718",
            "telephone_number": "586-323-4450",
            "fax_number": "586-323-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAGH",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101015629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4901604",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkavanagh7169@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "51221 Schoenherr Rd Ste 201",
            "city": "Shelby Twp",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483152718",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kkavanagh7169@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "51221 Schoenherr Rd Ste 201",
            "city": "Shelby Twp",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483152718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "WEST",
            "middle_name": "ELIZABETH",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• JV Sleep Diagnostics PLC (Michigan Adult & Pediatric Sleep Institute)
• Dawn M Kacy, DDS
• Braeanne Jeanine Kaczynski
• Mary R Karadsheh, PHARMD
• Gursharan Kaur
• Shavone Keith
• Elizabeth Kelly
• Nicholas Kepreos, DC
• Ketalityrx PLLC
• Kevin P. Murrell, D.D.S., P.C.

• Family Medicine Physician in Shelby TWP, MI
• Providers in Shelby TWP, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.