Katarzyna Noelle Brock, NP
Individual provider Active NPI Primary Care Nurse Practitioner · Eastpointe, MI
NPI 1235701798 · NPPES record last updated Aug 20, 2021
Key facts
- NPI
- 1235701798
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 4704267940 (MI)
- Practice address
- 19070 E 10 Mile Rd
Eastpointe, MI 48021-1449 - Phone
- (586) 445-0177
- Fax
- (585) 773-1385
- NPI assigned
- Jul 14, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210915001688 | MI | Practitioner - Nurse Practitioner | 9931505005 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ih Physician Services PC | Current |
Accepting new patients | |
| Vpa PC | Current | Accepting new patients | |
| Ih Physician Services, PC | Current |
Accepting new patients | |
| Maan Askar M.D. P.C | Current |
Accepting new patients | |
| Vpa PC | Current |
Accepting new patients | |
| Harmonycares Complete Health Services, PLLC | Current |
Accepting new patients | |
| Great Lakes Medical Group PC | Current |
Accepting new patients | |
| Vpa PC | Current |
Accepting new patients |
Locations
39425 Garfield Rd
Ste 22A
Clinton Township, MI 48038
Phone (586) 649-3181
19070 E 10 Mile Rd
Eastpointe, MI 48021
Phone (586) 445-0177
695 Kenmoor Ave SE
Ste B1
Grand Rapids, MI 49546
Phone (616) 438-9902
26211 Central Park Blvd
Ste 600
Southfield, MI 48076
Phone (248) 936-2075
500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060
13430 E 13 Mile Rd
Warren, MI 48088
Phone (248) 854-8999
26440 Hoover Rd
Ste C
Warren, MI 48089
Phone (586) 427-1337
655 Brawley School Rd
Ste 200
Mooresville, NC 28117
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 4704267940 | MI | Yes |
| Family Nurse Practitioner | 363LF0000X | 4704267940 | MI |
Addresses
Primary practice location
19070 E 10 Mile Rd
Eastpointe, MI 48021-1449
Mailing address
40020 Capitol Dr
Sterling Heights, MI 48313-5304
Phone (586) 335-5692
Other practice location 1
40020 Capitol Dr
Sterling Heights, MI 48313-5304
Phone (586) 335-5692
Other providers in Eastpointe, MI
- Ana Maria Brajak
- Susan Brandel
- Mary Ellen Brayton
- Aisha Braziel
- Brighter Day Counseling Services
- Shayna Marie Brown-Washington
- Keyonia Regina Brown
- Monique L Brown
- Ranesha Brown
- Sheila Brown
All providers in Eastpointe, MI · Primary Care Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.