Individual provider Active NPI

Andre C King, MD

  • Urology Physician
  • Chelsea, MI
National Provider Identifier
1588868426
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
4301105781 Issued in MI
Practice address
14650 E Old US Highway 12 # 5
Chelsea, MI 48118-1801
Phone
(734) 593-4220
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4301105781 MI Primary
Urology Physician 208800000X 52183-20 WI

Addresses

Primary practice location

14650 E Old US Highway 12 # 5
Chelsea, MI 48118-1801

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

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
I20140714000182 MI Practitioner - Urology 2466604004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
George Washington University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1301 Mercy Dr
Muskegon, MI 49444-1837
Phone (734) 936-7030

14650 E Old US Hwy 12
Chelsea, MI 48118-1801
Phone (734) 936-7030

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-7030

19900 Haggerty Rd
Suite 111
Livonia, MI 48152-1054
Phone (734) 936-7030

7500 Challis Rd
Brighton, MI 48116-9416
Phone (734) 936-7030

775 S Main St
Chelsea, MI 48118-1383
Phone (734) 936-7030

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52183-20WIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince Nov 1, 2025 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Nov 1, 2025 Accepting new patients
Regents of the University of Michigan Urology CurrentSince Aug 11, 2020 Accepting new patients
Regents of the University of Michigan CurrentSince Aug 11, 2020 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

14650 E Old US Highway 12
Ste 201
Chelsea, MI 48118
Phone (734) 433-4504

14650 E Old US Highway 12
Chelsea, MI 48118
Phone (734) 475-2600

14650 E Old US Highway 12
#5
Chelsea, MI 48118
Phone (734) 593-4220

14650 E Old US Highway 12
Ste 101
Chelsea, MI 48118
Phone (734) 475-3979

19900 Haggerty Rd
Ste 111
Livonia, MI 48152
Phone (734) 432-7811

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

4100 Campus Ridge Dr
Midland, MI 48640
Phone (989) 488-5450

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.

Hospital & facility affiliations 5

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1588868426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 E OLD US HIGHWAY 12 # 5",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181801",
            "telephone_number": "734-593-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "ANDRE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301105781",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "52183-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MI

Sources for this page

Verify at the official NPI Registry.