Kaitlyn Rose Kowalczyk, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704310971 Issued in MI

Practice address

3955 Patient Care Dr Ste a
Lansing, MI 48911-4271

Phone

(517) 374-7600

Fax

(855) 495-5457

NPI assigned

Oct 11, 2019

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

Other names 1

• Kaitlyn Rose Coon Former name

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

Nurse Practitioner

Education

Saginaw Valley Medical College - NLG, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capital Internal Medicine Associates P.C.Group PAC ID 8022097963, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kaitlyn.kowalczyk@cimamed.eclinicaldirectplus.com

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.

• Capital Internal Medicine Associates P.C.

  • Internal Medicine Physician
  • Lansing, MI
  • NPI 1780629832
  Medicare reassignment Care Compare group NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Plano, TX
  • NPI 1003811639
  NPD (past)

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1255973236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 PATIENT CARE DR STE A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114271",
            "telephone_number": "517-374-7600",
            "fax_number": "855-495-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 PATIENT CARE DR STE A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489114271",
            "telephone_number": "517-374-7600",
            "fax_number": "855-495-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALCZYK",
        "first_name": "KAITLYN",
        "middle_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704310971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "COON",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christine Kosnik, RSW
• Veera Pavan Kumar Kotaru, MD
• Indigo Skye Kotval, LPC
• Neena Lee Kovalchik, NP
• Cheryl Dawn Kovalski, D.O.
• Michael Casmir Kowalczyk, DO
• Lydia Kowaleski
• Joseph S. Kozlowski Jr., D.O.
• Tess Krage, DO
• Rachel Lyn Krahulik, RPH

• Family Nurse Practitioner in Lansing, MI
• Providers in Lansing, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.