Active NPI
Robert Jerome Kendell, D.O.
- Facial Plastic Surgery Physician
- Cadillac, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Facial Plastic Surgery Physician
- License
- 5101012647
- Practice address
- 8872 Professional Dr
Cadillac, MI 49601-8481 - Phone
- (231) 779-6260
- Fax
- (231) 779-6264
- NPI assigned
- Feb 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Facial Plastic Surgery Physician | 207YS0123X | 5101012647 | MI | Primary |
Addresses
Primary practice location
8872 Professional Dr
Cadillac, MI 49601-8481
Mailing address
8872 Professional Dr
Cadillac, MI 49601-8482
Phone (231) 779-6260
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4224164 | Medicaid | MI |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- At Still University of Health Sciences, College of Osteo Med, Kirksville, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8872 Professional Dr
Suite a
Cadillac, MI 49601-8482
Phone (231) 779-6260
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 20 |
| Removal or shaving of skin growth | 18 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert Kendell D.O.,P.C. | Facial Plastic Surgery | Current | Accepting new patients |
| Lisa Jacobson D.O., P.C. | Past | Accepting new patients |
Locations
8872 Professional Dr
Ste A
Cadillac, MI 49601
Phone (231) 775-9398
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Facial Plastic Surgery Physician
- Cadillac, MI
- NPI 1548562978
-
- Hearing Instrument Specialist
- Cadillac, MI
- NPI 1609274455
-
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- Cadillac, MI
- NPI 1831333715
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Munson Healthcare Cadillac Physician Network
- Family Medicine Physician
- Cadillac, MI
- NPI 1487051611
Hospital
-
- General Acute Care Hospital
- Cadillac, MI
- NPI 1841696754
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1366417578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8872 PROFESSIONAL DR",
"city": "CADILLAC",
"state": "MI",
"postal_code": "496018482",
"telephone_number": "231-779-6260",
"fax_number": "231-779-6264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8872 PROFESSIONAL DR",
"city": "CADILLAC",
"state": "MI",
"postal_code": "496018481",
"telephone_number": "231-779-6260",
"fax_number": "231-779-6264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDELL",
"first_name": "ROBERT",
"middle_name": "JEROME",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-21",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207YS0123X",
"taxonomy_group": "",
"desc": "Otolaryngology, Facial Plastic Surgery",
"state": "MI",
"license": "5101012647",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4224164",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cadillac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.