Individual provider Active NPI

Susan Lynn Kessler, MD

  • Pediatrics Physician
  • Royal Oak, MI
National Provider Identifier
1437170750
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301406679 Issued in MI
Practice address
3601 W 13 Mile Rd
FSC
Royal Oak, MI 48073-6712
Phone
(248) 423-2454
Fax
(248) 423-2576
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301406679 MI Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
FSC
Royal Oak, MI 48073-6712

Mailing address

3601 W 13 Mile Rd
FSC
Royal Oak, MI 48073-6712
Phone (248) 423-2454

Other identifiers 2

IdentifierTypeStateIssuer
350F361320OtherMIBCBSM
3458866MedicaidMI

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
I20100713000578 MI Practitioner - Pediatric Medicine 9032241997 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301406679MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Jun 1, 2019 Accepting new patients
Henry Ford Health St. John Hospital Pediatrics CurrentSince Jun 1, 2019 Accepting new patients
St. John Hospital Past Accepting new patients
William Beaumont Hospital Pediatrics Past Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22201 Moross Rd
Ste 270
Grosse Pointe, MI 48236
Phone (313) 343-3481

22201 Moross Rd
Ste 70
Grosse Pointe, MI 48236
Phone (313) 343-3700

46591 Romeo Plank Rd
Ste 205
Macomb, MI 48044
Phone (586) 226-6250

17900 23 Mile Rd
Ste 203
Macomb, MI 48044
Phone (586) 263-7400

17900 23 Mile Rd
Ste 101
Macomb, MI 48044
Phone (586) 868-9010

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

1135 W University Dr
Ste 355
Rochester Hills, MI 48307
Phone (248) 680-8060

3601 W 13 Mile Rd
Royal Oak, MI 48073

45634 Schoenherr Rd
Utica, MI 48315
Phone (586) 532-8440

Organizations & group practices 5

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437170750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "address_2": "FSC",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-423-2454",
            "fax_number": "248-423-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "address_2": "FSC",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-423-2454",
            "fax_number": "248-423-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESSLER",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301406679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "350F361320",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3458866",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.