Individual provider Active NPI

Amy Sue Kaluza

  • Emergency Medicine Physician
  • Grand Blanc, MI
National Provider Identifier
1437355229
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101015910 Issued in MI
Practice address
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone
(810) 606-5000
NPI assigned
Jun 27, 2007
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
Emergency Medicine Physician 207P00000X 5101015910 MI Primary

Addresses

Primary practice location

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Mailing address

12015 Torrey Rd
Fenton, MI 48430-9702

Other names 1

  • Amy Sue Gross Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071221000487 OR Practitioner - Emergency MedicinePractitioner - Osteopathic Manipulative Medicine 1759470487 Reassigns benefits to 2 organizations
I20200411000452 WA Practitioner - Emergency Medicine 1759470487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Osteopathic Manipulative Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Acute Care Specialists PCGroup PAC ID 7012807373, 46 clinicians

Practice addresses (Care Compare)

24800 SE Stark St
Gresham, OR 97030-3378
Phone (503) 674-1122

Hospital & facility affiliations

  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089

Merit-based Incentive Payment System (MIPS)

Final score
96.85 of 100Reported as group
Quality
84.92
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101015910MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Networks on Demand, LLC CurrentSince Jul 18, 2024 Accepting new patients
Northwest Acute Care Specialists PC Emergency Medicine CurrentSince Nov 1, 2007 Accepting new patients
Northwest Acute Care Specialists PC Emergency Medicine CurrentSince Nov 1, 2007 Accepting new patients

Locations

10221 SE Sunnyside Rd
Clackamas, OR 97015

2490 Willamette St
Ste 4
Eugene, OR 97405
Phone (541) 746-7671

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

172 NE Martin Luther King Jr Blvd
Portland, OR 97232

607 NE Grand Ave
Portland, OR 97232

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

2990 Commercial St SE
Ste 160
Salem, OR 97302

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

Organizations & group practices 3

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437355229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12015 TORREY RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALUZA",
        "first_name": "AMY",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101015910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "GROSS",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.