Active NPI
J.Adam Kellman, D.O.
- Family Medicine Physician
- Livonia, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101010588
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3099535 | 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
- 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
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
- Trinity Health at Home- Southeast Michigan
- Beaumont Hospital - Farmington Hills
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| 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 |
|---|---|---|---|
| Envision Medical Group PLLC | Family Medicine | Current | Accepting new patients |
| Inpatient Consultants of Michigan PC | Family Medicine | Current | Accepting new patients |
| VMD Primary Providers Eastern Michigan, PC | Family Medicine | Current | Accepting new patients |
| Envision Medical Group PLLC | Family Medicine | Current | Accepting new patients |
| Inpatient Consultants of Michigan PC | Current | Accepting new patients | |
| Livonia Family Physicians, PC | Family Medicine | Past | 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
- 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.
-
- Family Medicine Physician
- Novi, MI
- NPI 1336625540
-
- Hospitalist Physician
- Livonia, MI
- NPI 1861442824
-
- Family Medicine Physician
- Northville, MI
- NPI 1578891750
-
- Family Medicine Physician
- Northville, MI
- NPI 1821391848
-
- Hospitalist Physician
- Livonia, MI
- NPI 1891000964
Family Medicine
-
- Family Medicine Physician
- Brighton, MI
- NPI 1063677912
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
- Home Health Agency
- Troy, MI
- NPI 1992768550
-
- Home Health Agency
- Livonia, MI
- NPI 1508823774
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.