Individual provider Active NPI

Kimberly Cushman

  • Medical Physician Assistant
  • New Hudson, MI
National Provider Identifier
1194356055
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
30488 Milford Rd
New Hudson, MI 48165-8583
Phone
(484) 374-6252
Fax
(248) 437-4665
NPI assigned
Jan 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X MI Primary

Addresses

Primary practice location

30488 Milford Rd
New Hudson, MI 48165-8583

Mailing address

1034 W Ann Arbor TRL
Plymouth, MI 48170-1502
Phone (734) 667-5152

Other practice location 1

29531 Plymouth Rd
Livonia, MI 48150-2125
Phone (734) 525-7939

Other practice location 2

22990 Pontiac Trl
South Lyon, MI 48178-1641
Phone (248) 667-9202

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
I20210913002292 MI Practitioner - Physician Assistant 8426454638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care of Michigan PCGroup PAC ID 5799886313, 40 clinicians

Practice addresses (Care Compare)

11569 E 12 Mile Rd
Warren, MI 48093-2645
Phone (586) 582-0018

4403 Interpark Dr
Auburn Hills, MI 48326-1794
Phone (248) 276-3999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Michigan PC CurrentSince Jan 17, 2022 Accepting new patients
Healthy Urgent Care PLLC CurrentSince Oct 5, 2021 Accepting new patients
American Current Care of Michigan PC CurrentSince Jan 17, 2022 Accepting new patients
HPC Health PLLC PastSince May 31, 2020 Accepting new patients

Locations

436 44th St SE
Ste A
Kentwood, MI 49548
Phone (616) 531-9750

30488 Milford Rd
New Hudson, MI 48165
Phone (248) 412-3977

1034 W Ann Arbor Trl
Plymouth, MI 48170

11569 E 12 Mile Rd
Warren, MI 48093
Phone (586) 582-0018

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1194356055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 W ANN ARBOR TRL",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701502",
            "telephone_number": "734-667-5152",
            "fax_number": "734-667-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30488 MILFORD RD",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "481658583",
            "telephone_number": "484-374-6252",
            "fax_number": "248-437-4665"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29531 Plymouth Rd",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481502125",
            "country_code": "US",
            "telephone_number": "734-525-7939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22990 Pontiac Trl",
            "address_purpose": "LOCATION",
            "city": "South Lyon",
            "state": "MI",
            "postal_code": "481781641",
            "country_code": "US",
            "telephone_number": "248-667-9202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSHMAN",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hudson, MI

Sources for this page

Verify at the official NPI Registry.