Individual provider Active NPI

Gypsa Katoch

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1639522352
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301500191 Issued in MI
Practice address
4201 Saint Antoine St Ste 5B
Detroit, MI 48201-2153
Phone
(313) 745-1741
Fax
(313) 745-8165
NPI assigned
Jul 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301500191 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St Ste 5B
Detroit, MI 48201-2153

Mailing address

4201 Saint Antoine St # 5B
Detroit, MI 48201-2153
Phone (313) 745-1741

Other practice location 1

15540 Beech Daly Rd
Redford, MI 48239-3804
Phone (313) 387-5253

Other identifiers 1

IdentifierTypeStateIssuer
4301110120OtherMIMI STATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gkatoch6570645@direct.beaumont.edu

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
I20190829001996 MI Practitioner - Family Practice 7416285317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

15540 Beech Daly Rd
Redford, MI 48239-3804
Phone (313) 387-5253

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

Hospital & facility affiliations

  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory, LLC CurrentSince Feb 1, 2024 Accepting new patients
Oakwood Ambulatory LLC Family Medicine CurrentSince Feb 1, 2024 Accepting new patients
Botsford General Hospital Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

15540 Beech Daly Rd
Redford, MI 48239
Phone (313) 387-5253

Interoperability endpoints

  • Direct secure messaging: gkatoch6570645@direct.beaumont.edu
  • Direct secure messaging: gkatoch1698667@epic00.shdirect.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 8

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": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1639522352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST # 5B",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST STE 5B",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-1741",
            "fax_number": "313-745-8165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15540 Beech Daly Rd",
            "address_purpose": "LOCATION",
            "city": "Redford",
            "state": "MI",
            "postal_code": "482393804",
            "country_code": "US",
            "telephone_number": "313-387-5253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATOCH",
        "first_name": "GYPSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301500191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI STATE LICENSE",
            "identifier": "4301110120",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gkatoch6570645@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "15540 Beech Daly Rd",
            "city": "Redford",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482393804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.