Individual provider Active NPI

Kay Alexa Robertson, MD

  • Internal Medicine Physician
  • Pontiac, MI
National Provider Identifier
1649262080
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301068781 Issued in MI
Practice address
44200 Woodward Ave
Suite 205
Pontiac, MI 48341-5045
Phone
(248) 858-9400
Fax
(248) 858-9493
NPI assigned
Aug 22, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 4301068781 MI Primary
Pediatrics Physician 208000000X 4301068781 MI

Addresses

Primary practice location

44200 Woodward Ave
Suite 205
Pontiac, MI 48341-5045

Mailing address

44200 Woodward Ave
Suite 205
Pontiac, MI 48341-5045
Phone (248) 858-9400

Other identifiers 2

IdentifierTypeStateIssuer
05165444OtherEDFMG
5315008648OtherMICONTROLLED SUBSTANCE

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
I20040419000487 MI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 0446245484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

44200 Woodward Ave
Suite 205
Pontiac, MI 48341-5045
Phone (248) 858-9400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kay Robertson MD PC Internal Medicine CurrentSince Oct 14, 2004 Accepting new patients
St Joseph Mercy Hospital-SMHC Past Accepting new patients
Home Health Management PC Internal Medicine Past Accepting new patients
SJMH Medical Practice-SMHC Internal Medicine Past Accepting new patients
Hospitalist Physicians Medical Group of Michigan, PC PastSince Jan 28, 2024 Accepting new patients
Inpatient Consultants of Michigan PC Internal Medicine Past Accepting new patients

Locations

44200 Woodward Ave
Ste 205
Pontiac, MI 48341
Phone (248) 210-9466

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1649262080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE",
            "address_2": "SUITE 205",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415045",
            "telephone_number": "248-858-9400",
            "fax_number": "248-858-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE",
            "address_2": "SUITE 205",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415045",
            "telephone_number": "248-858-9400",
            "fax_number": "248-858-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "KAY",
        "middle_name": "ALEXA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301068781",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301068781",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDFMG",
            "identifier": "05165444",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "5315008648",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.