Individual provider Active NPI

Kaitlin Mary Henkel, M.S. PA-C

  • Physician Assistant
  • Ann Arbor, MI
National Provider Identifier
1649630625
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007565 Issued in MI
Practice address
1801 Briarwood Cir Ste 130
Ann Arbor, MI 48108-3347
Phone
(734) 998-7390
NPI assigned
Mar 3, 2016
Last updated
Feb 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007565 MI Primary

Addresses

Primary practice location

1801 Briarwood Cir Ste 130
Ann Arbor, MI 48108-3347

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160921002062 MI Practitioner - Physician Assistant 1759678519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1801 Briarwood Cir
Ann Arbor, MI 48108-3347
Phone (734) 539-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Medical Group PLLC Physician Assistant CurrentSince Oct 1, 2018 Accepting new patients
Envision Medical Group PLLC CurrentSince Oct 1, 2018 Accepting new patients
Regents of the University of Michigan Physician Assistant CurrentSince Feb 23, 2021 Accepting new patients
Regents of the University of Michigan CurrentSince Feb 23, 2021 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1801 Briarwood Cir
Ste 130
Ann Arbor, MI 48108
Phone (734) 998-7390

1801 Briarwood Cir
Ann Arbor, MI 48108
Phone (734) 539-5000

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

42931 7 Mile Rd
Northville, MI 48167
Phone (248) 348-2442

39475 Lewis Dr
Ste 130
Novi, MI 48377
Phone (248) 374-0502

Interoperability endpoints

  • Direct secure messaging: kaitlinhenkel@epicpc.allscriptsdirect.net

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, 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": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1649630625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 BRIARWOOD CIR STE 130",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083347",
            "telephone_number": "734-998-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKEL",
        "first_name": "KAITLIN",
        "middle_name": "MARY",
        "credential": "M.S. PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-03",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.