Individual provider Active NPI

Patricia A. Kaminski, C.N.P.

  • Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1538220470
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704193603 Issued in MI
Practice address
2799 W Grand Blvd
Department of Neurosurgery
Detroit, MI 48202-2608
Phone
(313) 916-1340
NPI assigned
Dec 13, 2006
Last updated
Dec 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704193603 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Department of Neurosurgery
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Department of Neurosurgery
Detroit, MI 48202-2608
Phone (313) 916-1340

Other practice location 1

4949 Coolidge Hwy
Royal Oak, MI 48073-1026
Phone (248) 655-5900

Other names 1

  • Ms. Patricia A. Longe Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pkaminski11971@direct.beaumont.edu
Direct Messaging Address pkaminski11971@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704193603MIMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: pkaminski11971@direct.beaumont.edu
  • Direct secure messaging: pkaminski16460@direct.hfhs.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1538220470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "DEPARTMENT OF NEUROSURGERY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "DEPARTMENT OF NEUROSURGERY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-1340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4949 Coolidge Hwy",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480731026",
            "country_code": "US",
            "telephone_number": "248-655-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMINSKI",
        "first_name": "PATRICIA",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704193603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pkaminski11971@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "address_2": "Department of Neurosurgery",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pkaminski11971@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "4949 Coolidge Hwy",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480731026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "LONGE",
            "middle_name": "A.",
            "prefix": "MS.",
            "credential": "C.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.