Individual provider Active NPI

Timothy Raymond Kessler, PA-C

  • Physician Assistant
  • Flint, MI
National Provider Identifier
1326215997
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002988 Issued in MI
Practice address
1352 S Linden Rd
Flint, MI 48532-4185
Phone
(810) 230-0001
Fax
(810) 230-0014
NPI assigned
May 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601002988 MI Primary

Addresses

Primary practice location

1352 S Linden Rd
Flint, MI 48532-4185

Mailing address

8245 Holly Rd
Ste 101
Grand Blanc, MI 48439-2443
Phone (810) 606-7500

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
I20080619000491 MI Practitioner - Physician Assistant 4385715309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

1080 S Van Dyke Rd
Suite 400
Bad Axe, MI 48413-9635
Phone (810) 245-7766

2685 Jolly Rd
Okemos, MI 48864-3553
Phone (517) 993-5900

37605 Pembroke Ave
Livonia, MI 48152-1050
Phone (734) 591-7931

8245 Holly Rd
Suite 101
Grand Blanc, MI 48439-2443
Phone (810) 606-7500

Merit-based Incentive Payment System (MIPS)

Final score
89.8 of 100Reported as group
Promoting interoperability
88
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601002988MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Audrey Bruell, M.D. P.C. Current Accepting new patients

Locations

37605 Pembroke Ave
Livonia, MI 48152
Phone (734) 591-7931

Interoperability endpoints

  • Direct secure messaging: timothy.kessler@qdp.emadirect.md

Organizations & group practices 2

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": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1326215997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8245 HOLLY RD",
            "address_2": "STE 101",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392443",
            "telephone_number": "810-606-7500",
            "fax_number": "810-606-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1352 S LINDEN RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324185",
            "telephone_number": "810-230-0001",
            "fax_number": "810-230-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSLER",
        "first_name": "TIMOTHY",
        "middle_name": "RAYMOND",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.