Kristina L Bahrou, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301105125 Issued in MI

Practice address

3830 Packard St Ste 230
Ann Arbor, MI 48108-2273

Phone

(734) 330-2110

NPI assigned

Jun 14, 2014

Last updated

Oct 1, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 24, 2024 through Jan 24, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: kristina.bahrou@707697576116228.direct.elationemr.com

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.

• Tree of Life Wellness PLC

  • Primary Care Clinic/Center
  • Ann Arbor, MI
  • NPI 1790326510
  Authorized official Same address or phone

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

{
    "created_epoch": "1402704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1598179822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3672 PROSPECT RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059534",
            "telephone_number": "734-890-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 PACKARD ST STE 230",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082273",
            "telephone_number": "734-330-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHROU",
        "first_name": "KRISTINA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-14",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301105125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James P Bagian, M.D.
• Brigit Devine Baglien
• Jaime T Bagnell-Leonardo, CRNA
• Robert A Bagramian, DDS
• Piroz Bahar, M.D.
• Wenyu Bai, MD
• Kari M Bail, NP-C
• Alexis Bailey, M.S., CCC-SLP
• Alison C Bailey
• Debra Bailey, MSW

• Family Medicine Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.