Revark David Kammo, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301098278 Issued in MI

Practice address

44405 Woodward Ave
Pontiac, MI 48341-5023

Phone

(248) 858-3000

NPI assigned

Jun 29, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians

St Michaels Internal Medicine Physicians PLLCGroup PAC ID 8022358563, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Choice Hospice Inc Hospice, Warren, MI, CCN 231658
• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkammo1134049@direct.hfhs.org
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• St. Michael'S Internal Medicine Physicians, PLLC

  • Internal Medicine Physician
  • West Bloomfield, MI
  • NPI 1205318722
  Medicare reassignment Care Compare group NPD Authorized official
• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Michigan PC

  • Hospitalist Physician
  • Livonia, MI
  • NPI 1861442824

  Internal Medicine

  Medicare reassignment NPD
• Michigan Healthcare Professionals PC

  • Diagnostic Radiology Physician
  • Westland, MI
  • NPI 1043559404
  NPD
• Michigan Healthcare Professionals PC

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD
• Clarkston Internal Medicine, P.C.

  • Internal Medicine Physician
  • Clarkston, MI
  • NPI 1417085085
  NPD (past)
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Choice Hospice Inc

  • Community Based Hospice Care Agency
  • Warren, MI
  • NPI 1952794133
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1326335241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4967 CROOKS RD",
            "address_2": "STE 130",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480985801",
            "telephone_number": "248-952-1601",
            "fax_number": "248-952-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMMO",
        "first_name": "REVARK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301098278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amitha Kakulavaram, M.D.
• Annie Kalapparambath, M.D
• Namdeo Kale, MD
• Shamla Kalyan, MD
• Kara Kaminski, CPHT
• Minisha Kanakarajan McKinney
• Mani Vignesh Kannan
• Anuja Dhaval Kapadia
• Sheri Lynn Kaplan, LMSW, ACSW
• Stacey Lynn Kaplan, LLMSW

• Internal Medicine Physician in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.