Individual provider Active NPI

Katherine Balogh

  • Family Medicine Physician
  • South Lyon, MI
National Provider Identifier
1497404123
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1497404123 Issued in MI
Practice address
23200 Pontiac TRL
South Lyon, MI 48178-1983
Phone
(248) 446-2935
NPI assigned
Mar 21, 2022
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1497404123 MI Primary

Addresses

Primary practice location

23200 Pontiac TRL
South Lyon, MI 48178-1983

Mailing address

23200 Pontiac TRL
South Lyon, MI 48178-1983

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
I20250620001416 MI Practitioner - Family Practice 5991183998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

23200 Pontiac TRL
South Lyon, MI 48178-1983

3200 W Liberty Rd
Suite C
Ann Arbor, MI 48103-9794
Phone (734) 761-2581

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1497404123MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
Iha Health Service Corporation CurrentSince Aug 1, 2025 Accepting new patients
Iha Health Services Corporation Family Medicine Past Accepting new patients

Locations

3200 W Liberty Rd
Ste C
Ann Arbor, MI 48103
Phone (734) 761-2581

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

23200 Pontiac Trl
South Lyon, MI 48178
Phone (248) 446-2935

Interoperability endpoints

  • Direct secure messaging: kbalogh4510293@direct.trinity-health.org
  • Direct secure messaging: kmullan1142402@direct.hfhs.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1497404123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23200 PONTIAC TRL",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23200 PONTIAC TRL",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781983",
            "telephone_number": "248-446-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALOGH",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "1497404123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lyon, MI

Sources for this page

Verify at the official NPI Registry.