Active NPI
Kristin Pacholke
- Physician Assistant
- Detroit, MI
National Provider Identifier
1427647957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601010550
- Practice address
- 259 Mack Ave
Detroit, MI 48201-2427 - Phone
- (313) 577-1716
- NPI assigned
- Jan 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601010550 | MI | Primary |
Addresses
Primary practice location
259 Mack Ave
Detroit, MI 48201-2427
Mailing address
259 Mack Ave
Detroit, MI 48201-2427
Other practice location 1
15010 Bishop St
Oak Park, MI 48237-1984
Phone (248) 345-6504
Other practice location 2
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-1994
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kpacholke3248956@epic00.corewelldirect.org |
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
Enrollment records 1
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
Practice addresses (Care Compare)
5301 E Huron River Dr
Ann Arbor, MI 48197-1051
Phone (734) 712-3456
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Joseph Mercy Hospital | Physician Assistant | Current | Accepting new patients |
| Saint Joseph Mercy Livingston Hospital | Current | Accepting new patients | |
| St Joseph Mercy Hospital | Current | Accepting new patients |
Locations
620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450
20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925
5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246
Interoperability endpoints
- kpacholke3248956@epic00.corewelldirect.org
- kpacholke1118517@direct.trinity-health.org
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.
-
- Otolaryngology Physician
- Ypsilanti, MI
- NPI 1659499705
-
- Surgery Physician
- Royal Oak, MI
- NPI 1578072906
-
- Emergency Medicine Physician
- Brighton, MI
- NPI 1285753236
-
- General Acute Care Hospital
- Brighton, MI
- NPI 1093748642
-
- Internal Medicine Physician
- Ypsilanti, MI
- NPI 1649399197
Physician Assistant
-
- Cardiac Rehabilitation Clinic/Center
- Ypsilanti, MI
- NPI 1902359094
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Trinity Heath Ann Arbor Hospital
- General Acute Care Hospital
- Ypsilanti, MI
- NPI 1780658443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749686400000",
"number": "1427647957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 MACK AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 MACK AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012427",
"telephone_number": "313-577-1716"
}
],
"practiceLocations": [
{
"address_1": "15010 Bishop St",
"address_purpose": "LOCATION",
"city": "Oak Park",
"state": "MI",
"postal_code": "482371984",
"country_code": "US",
"telephone_number": "248-345-6504",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3601 W 13 Mile Rd",
"address_purpose": "LOCATION",
"city": "Royal Oak",
"state": "MI",
"postal_code": "480736712",
"country_code": "US",
"telephone_number": "248-898-1994",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PACHOLKE",
"first_name": "KRISTIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-11",
"last_updated": "2025-06-12",
"certification_date": "2025-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601010550",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kpacholke3248956@epic00.corewelldirect.org",
"affiliation": "N",
"address_1": "3601 W 13 Mile Rd",
"city": "Royal Oak",
"state": "MI",
"country_code": "US",
"postal_code": "480736712",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; 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.