NPIMap

Individual provider Active NPI

Kate Lynette Cvetkovski

  • Physician Assistant
  • Bloomfield Hills, MI
National Provider Identifier
1336755156
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010221 Issued in MI
Practice address
4050 W Maple Rd
Bloomfield Hills, MI 48301-3148
Phone
(248) 885-8211
NPI assigned
Sep 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601010221 MI
Physician Assistant 363A00000X 5601010221 MI Primary

Addresses

Primary practice location

4050 W Maple Rd
Bloomfield Hills, MI 48301-3148

Mailing address

55772 Woodridge Dr
Shelby TWP, MI 48316-1037
Phone (248) 495-2154

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211230000716 MI Practitioner - Physician Assistant 8022409010 Reassigns benefits to 20 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Observation Medicine Group PLLCGroup PAC ID 6305001777, 29 clinicians
McLaren Hospital GroupGroup PAC ID 2365968351, 366 clinicians

Practice addresses (Care Compare)

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (810) 606-5733

50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 338-5000

Hospital & facility affiliations

  • Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197
  • McLaren Oakland Hospital, Pontiac, MI, CCN 230207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601010221MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
A3 Medical Current Accepting new patients
Taylor Urgent Care PC CurrentSince Sep 4, 2024 Accepting new patients
Doctors Urgent Care Southfield Past Accepting new patients

Locations

23234 Ecorse Rd
Taylor, MI 48180
Phone (313) 292-8400

Interoperability endpoints

  • Direct secure messaging: kcvetkovski1124261@direct.hfhs.org
  • Direct secure messaging: katecvetkovski@emcuramed.allscriptsdirect.net

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1336755156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55772 WOODRIDGE DR",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483161037",
            "telephone_number": "248-495-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 W MAPLE RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483013148",
            "telephone_number": "248-885-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CVETKOVSKI",
        "first_name": "KATE",
        "middle_name": "LYNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601010221",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.