Individual provider Active NPI

Kenneth J. Levin, M.D.

  • Radiation Oncology Physician
  • West Bloomfield, MI
National Provider Identifier
1265549422
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
4301058146 Issued in MI
Practice address
6777 W Maple Rd
Dept of Radiation Oncology Henry Ford Hospital
West Bloomfield, MI 48322-3013
Phone
(248) 661-6487
Fax
(248) 661-7164
NPI assigned
Aug 24, 2006
Last updated
Feb 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301058146 MI
Radiation Oncology Physician 2085R0001X 4301058146 MI Primary
Therapeutic Radiology Physician 2085R0203X 4301058146 MI

Addresses

Primary practice location

6777 W Maple Rd
Dept of Radiation Oncology Henry Ford Hospital
West Bloomfield, MI 48322-3013

Mailing address

6777 W Maple Rd
Dept of Radiation Oncology Henry Ford Hospital
West Bloomfield, MI 48322-3013
Phone (248) 661-6487

Other identifiers 4

IdentifierTypeStateIssuer
488605210MedicaidMI
KL058146OtherCHAMPUS-CHAMPUS
KL058146OtherCOMMERCIAL-COMMERCIAL NUMBER
700H262300OtherBLUE CROSS-BLUE CROSS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061101000591 MI Practitioner - Radiation OncologyPractitioner - Internal Medicine 3274530308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation OncologyAlso: Internal Medicine
Education
University of Michigan Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
W a Foote Memorial Hospital Inc Radiation Oncology CurrentSince Dec 29, 2019 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Dec 29, 2019 Accepting new patients
Henry Ford Health System Therapeutic Radiology CurrentSince Mar 6, 2006 Accepting new patients
W. a. Foote Memorial Hospital, Inc Internal Medicine Current Accepting new patients
Henry Ford Health System CurrentSince Mar 6, 2006 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients
Harper Hutzel Hospital Past Accepting new patients

Locations

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1102 E Michigan Ave
Jackson, MI 49201
Phone (517) 205-7299

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: klevin16853@direct.hfhs.org

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1265549422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "address_2": "DEPT OF RADIATION ONCOLOGY HENRY FORD HOSPITAL",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "248-661-6487",
            "fax_number": "248-661-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "address_2": "DEPT OF RADIATION ONCOLOGY HENRY FORD HOSPITAL",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "248-661-6487",
            "fax_number": "248-661-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "KENNETH",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301058146",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "4301058146",
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "MI",
            "license": "4301058146",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "488605210",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "KL058146",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "KL058146",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE CROSS",
            "identifier": "700H262300",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.