Individual provider Active NPI

Damian Kalisiewicz, M.D.

  • Internal Medicine Physician
  • Troy, MI
National Provider Identifier
1629459904
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1.060415 Issued in CT
Practice address
2891 E Maple Rd
Troy, MI 48083-6106
Phone
(248) 524-9085
Fax
(248) 524-9086
NPI assigned
Jun 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1.060415 CT Primary
Internal Medicine Physician 207R00000X 4301107096 MI

Addresses

Primary practice location

2891 E Maple Rd
Troy, MI 48083-6106

Mailing address

2891 E Maple Rd Ste 102
Troy, MI 48083-6106
Phone (248) 524-9085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180622000668 CT Practitioner - Hospitalist 1759693047 Reassigns benefits to 2 organizations
I20240819003383 MI Practitioner - Internal Medicine 1759693047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Metro Medical Practice PCGroup PAC ID 7214982784, 4 clinicians

Practice addresses (Care Compare)

2891 E Maple Rd
Suite 102
Troy, MI 48083-6103
Phone (248) 524-9085

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1.060415CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Middlesex Hospital Internal Medicine CurrentSince Mar 1, 2021 Accepting new patients
Middlesex Hospital CurrentSince Mar 1, 2021 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Metro Medical Practice PC Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

1000 Asylum Ave
Ste 4309B
Hartford, CT 06105

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

80 S Main St
Ste 102
Middletown, CT 06457
Phone (860) 358-6878

2891 E Maple Rd
Ste 102
Troy, MI 48083
Phone (248) 524-9085

Interoperability endpoints

  • Direct secure messaging: dkalisiewicz1133995@direct.hfhs.org
  • Direct secure messaging: dkalisiewicz64093@middlesexhealthprd.direct-ci.com

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 3

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": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1629459904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2891 E MAPLE RD STE 102",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480836106",
            "telephone_number": "248-524-9085",
            "fax_number": "248-524-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2891 E MAPLE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480836106",
            "telephone_number": "248-524-9085",
            "fax_number": "248-524-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALISIEWICZ",
        "first_name": "DAMIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "1.060415",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301107096",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.