Individual provider Active NPI

Kendra Lee Dolorfino, CPNP

  • Pediatric Nurse Practitioner
  • Big Rapids, MI
National Provider Identifier
1235637604
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704181225 Issued in MI
Practice address
650 Linden St Ste 4
Big Rapids, MI 49307
Phone
(231) 796-4470
NPI assigned
Jan 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704181225 MI Primary

Addresses

Primary practice location

650 Linden St Ste 4
Big Rapids, MI 49307

Mailing address

650 Linden St Ste 4
Big Rapids, MI 49307-1880
Phone (231) 796-4470

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
I20240830001583 MI Practitioner - Nurse Practitioner 3971042284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University PediatriciansGroup PAC ID 9638070568, 121 clinicians

Practice addresses (Care Compare)

3901 Beaubien St
Detroit, MI 48201-2119
Phone (313) 745-5870

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians CurrentSince Oct 1, 2024 Accepting new patients
University Pediatricians CurrentSince Oct 1, 2024 Accepting new patients

Locations

3901 Beaubien St
Ste H
Detroit, MI 48201
Phone (313) 745-5437

3901 Beaubien St
Fl 3
Detroit, MI 48201
Phone (313) 745-5906

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

Organizations & group practices 2

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": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1235637604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 LINDEN ST STE 4",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493071880",
            "telephone_number": "231-796-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 LINDEN ST STE 4",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "49307",
            "telephone_number": "231-796-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLORFINO",
        "first_name": "KENDRA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704181225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Rapids, MI

Sources for this page

Verify at the official NPI Registry.