Individual provider Active NPI

Jeffrey Hall Kozlow, M.D.

  • Plastic Surgery Physician
  • Ann Arbor, MI
National Provider Identifier
1417079765
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
4301084208 Issued in MI
Practice address
24 Frank Lloyd Wright Drive
Ann Arbor, MI 48105-9484
Phone
(734) 998-6022
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301084208 MI
Plastic Surgery Physician 208200000X 4301084208 MI Primary

Addresses

Primary practice location

24 Frank Lloyd Wright Drive
Ann Arbor, MI 48105-9484

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

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
I20110902000028 MI Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 4587797360 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: General Surgery
Education
Johns Hopkins University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, shared by 45 NPIs, 3,344 clinicians

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000

1500 E Medical Ctr Dr 1St FL
Taubman Ctr Rec D
Ann Arbor, MI 48109-5000
Phone (734) 936-4185

1500 E Medical Ctr Dr 1St FL Rec D
Taubman Center
Ann Arbor, MI 48109-5000
Phone (734) 764-5175

1500 E Medical Ctr Dr 1St FL Rec F
Mott Hospital
Ann Arbor, MI 48109-5000
Phone (734) 764-5176

1500 E Medical Ctr Dr 3Rd FL Taubma
Ann Arbor, MI 48109-5000
Phone (734) 647-7321

2098 S Main St
Ann Arbor, MI 48103-5827

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484

4260 Plymouth Rd
Ann Arbor, MI 48109-2700

4270 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (888) 287-1082

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Plastic Surgery CurrentSince Jul 26, 2011 Accepting new patients
Edward W. Sparrow Hospital Association Plastic Surgery CurrentSince Apr 17, 2024 Accepting new patients
Edward W Sparrow Hospital Association Surgery Current Accepting new patients
Regents of the University of Michigan CurrentSince Jul 26, 2011 Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Regents of the University of Michigan Surgery CurrentSince Mar 14, 2020 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Apr 17, 2024 Accepting new patients
Regents of the University of Michigan Past Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

3621 S State St
#700
Ann Arbor, MI 48108

1500 E Medical Center Dr
Fl 3
Ann Arbor, MI 48109
Phone (734) 647-5944

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

2098 S Main St
Ann Arbor, MI 48103
Phone (734) 936-5780

1500 E Medical Center Dr
#D
Ann Arbor, MI 48109
Phone (734) 936-5823

7500 Challis Rd
Fl 1
Brighton, MI 48116
Phone (810) 263-4000

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

1210 W Saginaw St
Lansing, MI 48915
Phone (517) 364-7180

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1200 E Michigan Ave
Ste 655
Lansing, MI 48912
Phone (517) 267-2460

Organizations & group practices 9

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 1

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1417079765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DRIVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-998-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOW",
        "first_name": "JEFFREY",
        "middle_name": "HALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301084208",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301084208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.