Kelsey Anne Brengman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601009233 Issued in MI

Practice address

20769 E 13 Mile Rd
Roseville, MI 48066-4503

Phone

(586) 872-2288

NPI assigned

May 24, 2019

Last updated

May 21, 2024By 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

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

Specialty

Physician Assistant

Education

Wayne State University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Roseville Urgent Care PCGroup PAC ID 8921281361, 21 clinicians

Hoover Urgent Care of Warren PLLCGroup PAC ID 6204073752, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Hoover Urgent Care of Warren PLLC

  • Urgent Care Clinic/Center
  • Warren, MI
  • NPI 1821351610
  Medicare reassignment Care Compare group
• Roseville Urgent Care, PC

  • Urgent Care Clinic/Center
  • Roseville, MI
  • NPI 1811297070
  Medicare reassignment Care Compare group
• Get Well Urgent Care Macomb PLC

  • Urgent Care Clinic/Center
  • Clinton TWP, MI
  • NPI 1073289013
  Medicare reassignment
• Get Well Urgent Care Shelby PLC

  • Urgent Care Clinic/Center
  • Shelby Township, MI
  • NPI 1033865464
  Medicare reassignment

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1225695232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 SAINT CHARLES CT",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671928",
            "telephone_number": "313-820-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20769 E 13 MILE RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664503",
            "telephone_number": "586-872-2288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26000 Hoover Rd",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480891167",
            "country_code": "US",
            "telephone_number": "586-722-0707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENGMAN",
        "first_name": "KELSEY",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-24",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bormans Inc (Farmer Jack Pharmacy)
• Amanda Bour, NP
• Earl Benjamin Boyd III
• Hillary Brass, CNM
• Rebecca L Bremer, DO
• Robert Brinker, OD
• Lisa Gaye Brooks, LLP
• Bruce G. Johnson, Dopc
• Henry Gasson Bryan, D.D.S.
• David Peter Bryk, DDS

• Physician Assistant in Roseville, MI
• Providers in Roseville, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.