Individual provider Active NPI

J.Adam Kellman, D.O.

  • Family Medicine Physician
  • Livonia, MI
National Provider Identifier
1386624187
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101010588 Issued in MI
Practice address
17800 Newburgh Rd
Suite 103
Livonia, MI 48152-2700
Phone
(734) 464-9540
Fax
(734) 464-0438
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101010588 MI Primary

Addresses

Primary practice location

17800 Newburgh Rd
Suite 103
Livonia, MI 48152-2700

Mailing address

17800 Newburgh Rd
Suite 103
Livonia, MI 48152-2700
Phone (734) 464-9540

Other identifiers 1

IdentifierTypeStateIssuer
3099535MedicaidMI

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
I20060613000290 MI Practitioner - Family PracticePractitioner - Internal Medicine 1759393622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
VMD Primary Providers Eastern Michigan PCGroup PAC ID 9234480575, 63 clinicians

Practice addresses (Care Compare)

17800 Newburgh Rd
103 Livonia Family Physicians
Livonia, MI 48152-2794
Phone (734) 464-9540

Hospital & facility affiliations

  • Residential Home Health Home health agency, Troy, MI, CCN 237459
  • Trinity Health at Home- Southeast Michigan Home health agency, Livonia, MI, CCN 237069
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Medical Group PLLC Family Medicine CurrentSince Jun 1, 2010 Accepting new patients
Inpatient Consultants of Michigan PC Family Medicine CurrentSince May 26, 2010 Accepting new patients
VMD Primary Providers Eastern Michigan, PC Family Medicine CurrentSince Sep 4, 2021 Accepting new patients
Envision Medical Group PLLC Family Medicine CurrentSince Jun 1, 2010 Accepting new patients
Inpatient Consultants of Michigan PC CurrentSince May 26, 2010 Accepting new patients
Livonia Family Physicians, PC Family Medicine PastSince Mar 1, 2007 Accepting new patients

Locations

6700 Westside Saginaw Rd
Bay City, MI 48706
Phone (989) 667-9800

1014 E Grand River Ave
Brighton, MI 48116
Phone (810) 220-5222

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

23550 Haggerty Rd
Farmington Hills, MI 48335
Phone (248) 381-8081

111 Trealout Dr
Fenton, MI 48430
Phone (810) 629-4105

G3201 Beecher Rd
Flint, MI 48532
Phone (810) 732-9200

17800 Newburgh Rd
Ste 103
Livonia, MI 48152
Phone (734) 464-9540

1211 Stateline Rd
Niles, MI 49120
Phone (269) 684-2810

42931 7 Mile Rd
Northville, MI 48167
Phone (248) 348-2442

39475 Lewis Dr
Ste 200
Novi, MI 48377
Phone (248) 471-0675

39475 Lewis Dr
Ste 130
Novi, MI 48377
Phone (248) 374-0502

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Interoperability endpoints

  • Direct secure messaging: j.adam.kellman.1@21803.direct.athenahealth.com

Organizations & group practices 6

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 10

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386624187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17800 NEWBURGH RD",
            "address_2": "SUITE 103",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522700",
            "telephone_number": "734-464-9540",
            "fax_number": "734-464-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 NEWBURGH RD",
            "address_2": "SUITE 103",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522700",
            "telephone_number": "734-464-9540",
            "fax_number": "734-464-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLMAN",
        "first_name": "J.ADAM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101010588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3099535",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.