Individual provider Active NPI

Mark A Kalt, D.O.

  • Anesthesiology Physician
  • Warren, MI
National Provider Identifier
1316980808
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
5101010586 Issued in MI
Practice address
11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone
(586) 573-5260
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 5101010586 MI Primary

Addresses

Primary practice location

11800 E 12 Mile Rd
Warren, MI 48093-3472

Mailing address

7 W Square Lake Rd
Bloomfield Hills, MI 48302-0462

Other identifiers 3

IdentifierTypeStateIssuer
2973453-11MedicaidMI
0555021645OtherMIBCBS
3405058-11MedicaidMI

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
I20071019000592 MI Practitioner - Anesthesiology 8628164787 Reassigns benefits to 6 organizations
Practice locations: Rochester Hills, MI

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Services, LLC Current Accepting new patients
Straith Hospital for Special Surgery CurrentSince Nov 10, 2018 Accepting new patients
Anesthesia Services Associates, PC Anesthesiology CurrentSince Dec 5, 2018 Accepting new patients
Ambulatory Anesthesia Associates, PC Anesthesiology CurrentSince Aug 7, 2018 Accepting new patients
Northwestern Services, LLC Anesthesiology CurrentSince Oct 1, 2018 Accepting new patients
Straith Hospital for Special Surgery Anesthesiology CurrentSince Nov 10, 2018 Accepting new patients
Straith Hospital for Special Surgery Current Accepting new patients
Novi Aas LLC Anesthesiology CurrentSince Aug 15, 2025 Accepting new patients
Eastside Group LLC Anesthesiology CurrentSince Aug 24, 2009 Accepting new patients
Straith Hospital for Special Surgery Past Accepting new patients

Locations

30055 Northwestern Hwy
Ste L-60
Farmington Hills, MI 48334
Phone (248) 265-6555

3800 Centennial Dr
Grass Lake, MI 49240
Phone (517) 701-3100

25500 Meadowbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 477-0220

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

432 W University Dr
Rochester, MI 48307
Phone (248) 651-6122

23901 Lahser Rd
Southfield, MI 48033
Phone (248) 357-3360

28963 Little Mack Ave
Ste 10
St Clr Shores, MI 48081
Phone (586) 447-5110

230 W Maple Rd
Troy, MI 48084
Phone (248) 244-1500

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: mark.kalt.1@11987.direct.athenahealth.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1316980808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 W SQUARE LAKE RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALT",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "5101010586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2973453-11",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0555021645",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405058-11",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.