NPIMap

Individual provider Active NPI

Marvin Laith Kajy, M.D.

  • Cardiovascular Disease Physician
  • Grand Rapids, MI
National Provider Identifier
1346774981
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301501728 Issued in MI
Practice address
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone
(248) 483-1731
NPI assigned
Apr 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301501728 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

100 Michigan St NE
Grand Rapids, MI 49503-2560

Mailing address

28632 Appleblossom LN
Farmington Hills, MI 48331-2403
Phone (248) 483-1731

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
I20211216000431 MI Practitioner - Internal Medicine 1254609431 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Halo Medical Group PLLCGroup PAC ID 1850587890, 17 clinicians

Practice addresses (Care Compare)

30229 Schoenherr Rd
Warren, MI 48088-6858
Phone (586) 573-7971

4160 John R St
Suite 510
Detroit, MI 48201-2021
Phone (313) 993-7777

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Halo Medical Group PLLC Cardiovascular Disease CurrentSince May 1, 2024 Accepting new patients
Henry Ford Health Providence Hospital Cardiovascular Disease CurrentSince Dec 6, 2025 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Feb 1, 2026 Accepting new patients
MVP Endovascular Center PLLC Cardiovascular Disease CurrentSince Feb 1, 2025 Accepting new patients
Henry Ford Health St. John Hospital Cardiovascular Disease CurrentSince Feb 1, 2026 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Nov 24, 2021 Accepting new patients
Henry Ford Health Providence Hospital CurrentSince Dec 6, 2025 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Nov 24, 2021 Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients

Locations

22720 Michigan Ave
Ste 200
Dearborn, MI 48124
Phone (313) 791-3000

22720 Michigan Ave
Ste 300
Dearborn, MI 48124
Phone (313) 791-3000

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

4160 John R St
Ste 510
Detroit, MI 48201
Phone (313) 993-7777

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

22201 Moross Rd
Grosse Pointe Woods, MI 48236
Phone (313) 343-3481

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

26850 Providence Pkwy
Ste 205
Novi, MI 48374
Phone (248) 465-3144

16001 W 9 Mile Rd
Fl 5
Southfield, MI 48075
Phone (248) 380-4335

20240 W 12 Mile Rd
Southfield, MI 48076
Phone (248) 331-1400

30229 Schoenherr Rd
Warren, MI 48088
Phone (586) 573-7971

Interoperability endpoints

  • Direct secure messaging: mkajy360101@direct.hfhs.org

Organizations & group practices 11

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.

Hospital & facility affiliations 5

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1346774981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28632 APPLEBLOSSOM LN",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483312403",
            "telephone_number": "248-483-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "248-483-1731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAJY",
        "first_name": "MARVIN",
        "middle_name": "LAITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301501728",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.