Individual provider Active NPI

Harry Alger Kezelian Jr., D.P.M.

  • Podiatrist
  • Southfield, MI
National Provider Identifier
1629083035
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001098 Issued in MI
Practice address
29877 Telegraph Rd Ste 200
Southfield, MI 48034-7659
Phone
(248) 354-0057
Fax
(248) 809-6071
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901001098 MI Primary

Addresses

Primary practice location

29877 Telegraph Rd Ste 200
Southfield, MI 48034-7659

Mailing address

29877 Telegraph Rd Ste 200
Southfield, MI 48034-7659
Phone (248) 354-0057

Other identifiers 1

IdentifierTypeStateIssuer
3113830MedicaidMI

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051128000079 MI Practitioner - Podiatry 2961422688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

29877 Telegraph Rd
Suite 200
Southfield, MI 48034-7659
Phone (248) 354-0057

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5901001098MIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Harry a Kezelian Jr D P M P C Podiatrist CurrentSince Jan 1, 1994 Accepting new patients
Polyclinic Associates PC Past Accepting new patients
Foot and Ankle Institute of Michigan PLLC Podiatrist Past Accepting new patients

Locations

4160 John R St
Ste 1012
Detroit, MI 48201
Phone (313) 831-6442

27207 Lahser Rd
Ste 250A
Southfield, MI 48034
Phone (248) 424-8637

22401 Foster Winter Dr
Southfield, MI 48075
Phone (248) 423-4100

29877 Telegraph Rd
Ste 200
Southfield, MI 48034
Phone (248) 354-0730

Interoperability endpoints

  • Direct secure messaging: hkezelia@direct.dmc.org
  • Direct secure messaging: hkezelian@hakjdp-mi.direct.office.nextgen.com
  • Direct secure messaging: hkezelian1134558@direct.hfhs.org

Organizations & group practices 3

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 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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768003200000",
    "number": "1629083035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29877 TELEGRAPH RD STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347659",
            "telephone_number": "248-354-0057",
            "fax_number": "248-809-6071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29877 TELEGRAPH RD STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347659",
            "telephone_number": "248-354-0057",
            "fax_number": "248-809-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEZELIAN",
        "first_name": "HARRY",
        "middle_name": "ALGER",
        "name_suffix": "Jr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3113830",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.