Individual provider Active NPI

Kendall Pieroni, PA-C

  • Physician Assistant
  • Ferndale, MI
National Provider Identifier
1417612136
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010822 Issued in MI
Practice address
928 E 10 Mile Rd Ste 400
Ferndale, MI 48220-3041
Phone
(248) 268-4296
Fax
(888) 850-3877
NPI assigned
Nov 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601010822 MI
Physician Assistant 363A00000X 5601010822 MI Primary

Addresses

Primary practice location

928 E 10 Mile Rd Ste 400
Ferndale, MI 48220-3041

Mailing address

PO Box 71587
Madison Heights, MI 48071-0587
Phone (248) 268-4296

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211215000107 MI Practitioner - Physician Assistant 4284024878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elizabeth a Pensler DO PLLCGroup PAC ID 6305140880, 6 clinicians

Practice addresses (Care Compare)

928 E 10 Mile Rd
Ferndale, MI 48220-1043
Phone (248) 268-4296

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601010822MIMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: kjohnson1551179@direct.trinity-health.org
  • Direct secure messaging: kpieroni937427@direct.hfhs.org

Organizations & group practices 2

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": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1417612136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71587",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480710587",
            "telephone_number": "248-268-4296",
            "fax_number": "888-850-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 E 10 MILE RD STE 400",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482203041",
            "telephone_number": "248-268-4296",
            "fax_number": "888-850-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERONI",
        "first_name": "KENDALL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601010822",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, MI

Sources for this page

Verify at the official NPI Registry.