Individual provider Active NPI

Genise Eilender Kerner, M.D.

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1376512863
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301045002 Issued in MI
Practice address
29275 Northwestern Hwy Ste 202
Southfield, MI 48034-5744
Phone
(248) 996-8332
Fax
(734) 779-5050
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301045002 MI Primary

Addresses

Primary practice location

29275 Northwestern Hwy Ste 202
Southfield, MI 48034-5744

Mailing address

29275 Northwestern Hwy Ste 202
Southfield, MI 48034-5744
Phone (248) 996-8332

Other identifiers 1

IdentifierTypeStateIssuer
1376512863MedicaidMI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040709001371 MI Practitioner - Internal Medicine 2567449994 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301045002MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genise Kerner MD PC CurrentSince May 1, 2018 Accepting new patients
M&Y Care, LLC CurrentSince May 21, 2024 Accepting new patients
M&Y Care, LLC CurrentSince May 21, 2024 Accepting new patients

Locations

29275 Northwestern Hwy
Ste 202
Southfield, MI 48034
Phone (248) 727-1990

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17748/brand/1/csg/1/fhir/r4
  • Direct secure messaging: gkerner58357@direct.hfhs.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1376512863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29275 NORTHWESTERN HWY STE 202",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345744",
            "telephone_number": "248-996-8332",
            "fax_number": "734-779-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29275 NORTHWESTERN HWY STE 202",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345744",
            "telephone_number": "248-996-8332",
            "fax_number": "734-779-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNER",
        "first_name": "GENISE",
        "middle_name": "EILENDER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301045002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376512863",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.