Individual provider Active NPI

John Amir Kellow, M.D.

  • Anesthesiology Physician
  • Saginaw, MI
National Provider Identifier
1295714053
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301080744 Issued in MI
Practice address
700 Cooper Ave
Saginaw, MI 48602-5383
Phone
(989) 583-6200
NPI assigned
Jan 11, 2006
Last updated
Nov 15, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301080744 MI Primary

Addresses

Primary practice location

700 Cooper Ave
Saginaw, MI 48602-5383

Mailing address

4344 State St
Saginaw, MI 48603-4074
Phone (989) 791-0452

Other identifiers 2

IdentifierTypeStateIssuer
4538602MedicaidMI
JK080744OtherBCBSM

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
I20080726000059 MI Practitioner - Anesthesiology 4789694928 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Michigan PLLCGroup PAC ID 9638481591, 192 clinicians

Practice addresses (Care Compare)

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3615

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301080744MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan PLLC Anesthesiology CurrentSince Jun 1, 2015 Accepting new patients
Northstar Anesthesia of Michigan III PLLC CurrentSince Jan 1, 2021 Accepting new patients
Northstar Anesthesia of Michigan II PC Anesthesiology Past Accepting new patients
Community Anesthesia & Pain Treatment, LLC Anesthesiology Past Accepting new patients
Advanced Anesthesia Associates, PLLC Anesthesiology Past Accepting new patients

Locations

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

5450 Fort St
Woodhaven, MI 48183
Phone (734) 671-3297

6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496

Interoperability endpoints

  • Direct secure messaging: jkellow@direct.dmc.org

Organizations & group practices 5

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 1

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1295714053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4344 STATE ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486034074",
            "telephone_number": "989-791-0452",
            "fax_number": "989-791-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 COOPER AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025383",
            "telephone_number": "989-583-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOW",
        "first_name": "JOHN",
        "middle_name": "AMIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301080744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4538602",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "JK080744",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.