Individual provider Active NPI

Michael F Ksycki, DO

  • Surgery Physician
  • Saginaw, MI
National Provider Identifier
1194975334
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OS10488 Issued in FL
Practice address
1500 Weiss St
Saginaw, MI 48602-5251
Phone
(989) 497-2500
NPI assigned
Sep 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OS10488 FL Primary
Surgical Critical Care Physician 2086S0102X OS10488 FL

Addresses

Primary practice location

1500 Weiss St
Saginaw, MI 48602-5251

Mailing address

1500 Weiss St
Saginaw, MI 48602-5251
Phone (989) 497-2500

Other identifiers 1

IdentifierTypeStateIssuer
0005551-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120314000686 TX Practitioner - General SurgeryPractitioner - Critical Care (Intensivists)Practitioner - Other (Physician) 3971665530 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS10488FLMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
US Health Dept of Health & Human Services Current Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Feb 8, 2012 Accepting new patients
U S Health Dept of Health & Human Services CurrentSince Feb 8, 2012 Accepting new patients

Locations

669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100

Organizations & group practices 3

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": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1194975334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WEISS ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025251",
            "telephone_number": "989-497-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WEISS ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025251",
            "telephone_number": "989-497-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KSYCKI",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-24",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "OS10488",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "OS10488",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005551-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.