Mark P Kallaway, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

4301070855 Issued in MI

Practice address

1501 W Chisholm St
Alpena, MI 49707-1401

Phone

(989) 356-7390

Fax

(989) 356-7794

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• House MDS PLC

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1790411221
  Medicare reassignment NPD
• Insight Anesthesia PLLC

  • Anesthesiology Physician
  • Flint, MI
  • NPI 1952775975
  Medicare reassignment NPD
• Jawad a Shah, MD PC

  • Specialist
  • Flint, MI
  • NPI 1942402391
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1396835146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9750 US HIGHWAY 23 N",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497078948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W CHISHOLM ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071401",
            "telephone_number": "989-356-7390",
            "fax_number": "989-356-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLAWAY",
        "first_name": "MARK",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301070855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN",
            "identifier": "P00108478",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MICHIGAN",
            "identifier": "0500401082",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4452025",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Stephen Kadrich, D.C.
• Lauren Jane Kadrich, D.C.
• James E Kaiser, CERTIFIED OPTICIAN
• Nicole Kathleen Kaiser
• William Kaiser, LMSW
• Amy L Kane, F.N.P.
• Sean Thomas Kane, FNP
• Andrew Kanny
• Renee Karsaba
• Mark Allen Karsten, OD

• Anesthesiology Physician in Alpena, MI
• Providers in Alpena, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.