Kathryn Irene Idzikowski, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704280994 Issued in MI

Practice address

11800 E 12 Mile Rd
Warren, MI 48093

Phone

(586) 573-5059

NPI assigned

Mar 17, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Water Urgent Care PLLCGroup PAC ID 8123427895, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Blue Water Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Fort Gratiot, MI
  • NPI 1477135036
  Medicare reassignment Care Compare group NPD
• Observation Emergency Physicians, P.C.

  • Emergency Medicine Physician
  • Detroit, MI
  • NPI 1497920524
  Medicare reassignment NPD
• Seton Health Corporation of Southeastern Michigan

  • Family Medicine Physician
  • Clinton Township, MI
  • NPI 1598177065
  Medicare reassignment NPD
• Wyandotte Urgent Care Clinic

  • Urgent Care Clinic/Center
  • Wyandotte, MI
  • NPI 1316467384
  Medicare reassignment NPD
• Emergency Department Physicians, P.C.

  • Emergency Medicine Physician
  • Detroit, MI
  • NPI 1225083595
  Medicare reassignment
• Seton Health Corporation of Southeastern Michigan

  • Physical Therapy Clinic/Center
  • Macomb, MI
  • NPI 1487067260
  NPD
• Blue Water Urgent Care New Baltimore

  • Urgent Care Clinic/Center
  • New Baltimore, MI
  • NPI 1235841362
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regents of the University of Michigan

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1578004941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-306-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDZIKOWSKI",
        "first_name": "KATHRYN",
        "middle_name": "IRENE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-17",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704280994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• I Care Home Provider Inc
• Ghaith M Ibrahim, MD
• Vivian Ibrahim
• Alexander Icardi, DPM
• Ideal Home Care LLC
• Ivana Ilievska
• Indulgent Loving Care LLC
• Infection Solution PLLC
• Infinity Home Help LLC
• Injury MD

• Family Nurse Practitioner in Warren, MI
• Providers in Warren, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.

Verify at the official NPI Registry.