Individual provider Active NPI

Michelle Malaj, NP

  • Family Nurse Practitioner
  • Chesterfield, MI
National Provider Identifier
1316728165
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704364381 Issued in MI
Practice address
30170 23 Mile Rd
Chesterfield, MI 48047-2190
Phone
(586) 949-5900
Fax
(586) 949-5922
NPI assigned
Oct 9, 2023
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704364381 MI Primary

Addresses

Primary practice location

30170 23 Mile Rd
Chesterfield, MI 48047-2190

Mailing address

7500 Cornwall CT
West Bloomfield, MI 48322-4073

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231026003861 MI Practitioner - Nurse Practitioner 9032565007 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704364381MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kenwood Allergy & Asthma Center, P.C. CurrentSince Oct 1, 2023 Accepting new patients

Locations

30170 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 949-5900

17965 Hall Rd
Macomb, MI 48044
Phone (586) 465-4722

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1316728165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 CORNWALL CT",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30170 23 MILE RD",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480472190",
            "telephone_number": "586-949-5900",
            "fax_number": "586-949-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAJ",
        "first_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704364381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MI

Sources for this page

Verify at the official NPI Registry.