Individual provider Active NPI

Jeffrey A Kepes, MD

  • Allergy & Immunology Physician
  • Owosso, MI
National Provider Identifier
1316334253
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
4301501309 Issued in MI
Practice address
317 S Elm St Ste 205a
Owosso, MI 48867-2636
Phone
(989) 729-4317
Fax
(989) 725-9979
NPI assigned
Apr 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Allergy/Immunology Physician 2080P0201X 4301501309 MI
Allergy & Immunology Physician 207K00000X 4301501309 MI Primary

Addresses

Primary practice location

317 S Elm St Ste 205a
Owosso, MI 48867-2636

Mailing address

317 S Elm St Ste 205a
Owosso, MI 48867-2636
Phone (989) 729-4317

Other identifiers 1

IdentifierTypeStateIssuer
1316334253MedicaidMI

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
I20200624000203 MI Practitioner - Pediatric MedicinePractitioner - Allergy/ImmunologyPractitioner - Internal Medicine 1052632205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Allergy/Immunology, Internal Medicine
Education
Wayne State University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Practice addresses (Care Compare)

317 S Elm St
205A Memorial Healthcare Allergy and Immunolo
Owosso, MI 48867-2649
Phone (989) 729-4317

3337 Britton Rd
Perry, MI 48872-9706
Phone (517) 625-3004

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301501309MIMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians CurrentSince Jun 1, 2020 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Feb 21, 2024 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Feb 21, 2024 Accepting new patients
Memorial Hospital Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Feb 21, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Memorial Hospital CurrentSince Jul 1, 2024 Accepting new patients
University Pediatricians CurrentSince Jun 1, 2020 Accepting new patients
Memorial Hospital CurrentSince Jul 1, 2024 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Feb 21, 2024 Accepting new patients
Memorial Hospital Past Accepting new patients

Locations

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

3950 Beaubien St
Detroit, MI 48201
Phone (313) 745-5437

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

113 E Williams St
Owosso, MI 48867
Phone (989) 725-6101

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

519 S Monroe Ave
Green Bay, WI 54301
Phone (920) 435-6601

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Organizations & group practices 12

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.

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": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1316334253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 S ELM ST STE 205A",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672636",
            "telephone_number": "989-729-4317",
            "fax_number": "989-725-9979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 S ELM ST STE 205A",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672636",
            "telephone_number": "989-729-4317",
            "fax_number": "989-725-9979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPES",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-17",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "MI",
            "license": "4301501309",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "4301501309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316334253",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owosso, MI

Sources for this page

Verify at the official NPI Registry.