Individual provider Active NPI

Preeti S Kelkar, M.D.

  • Radiation Oncology Physician
  • Garden City, MI
National Provider Identifier
1336312867
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
4301041652 Issued in MI
Practice address
6255 Inkster Rd
Ste B-7
Garden City, MI 48135-2577
Phone
(734) 522-8540
Fax
(734) 522-5405
NPI assigned
Apr 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 4301041652 MI Primary

Addresses

Primary practice location

6255 Inkster Rd
Ste B-7
Garden City, MI 48135-2577

Mailing address

42010 Baintree Cir
Northville, MI 48168-2363
Phone (248) 348-0788

Other identifiers 1

IdentifierTypeStateIssuer
4301041652OtherMIMICHIGAN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301041652MIMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiation Therapy Associates PC Radiation Oncology PastSince May 1, 2004 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1336312867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42010 BAINTREE CIR",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481682363",
            "telephone_number": "248-348-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 INKSTER RD",
            "address_2": "STE B-7",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352577",
            "telephone_number": "734-522-8540",
            "fax_number": "734-522-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELKAR",
        "first_name": "PREETI",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "4301041652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "4301041652",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.