NPIMap

Individual provider Active NPI

Justin Robert Kapke, PA

  • Physician Assistant
  • Charlevoix, MI
National Provider Identifier
1679397640
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012888 Issued in MI
Practice address
14695 Park Ave Ste a
Charlevoix, MI 49720-1920
Phone
(321) 487-2270
NPI assigned
Nov 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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 5601012888 MI Primary

Addresses

Primary practice location

14695 Park Ave Ste a
Charlevoix, MI 49720-1920

Mailing address

1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-5000

Other practice location 1

1619 Anderson Rd
Petoskey, MI 49770-9256
Phone (231) 417-6075

Other practice location 2

829 N Center Ave Ste 260
Gaylord, MI 49735-1597
Phone (989) 731-6405

Other practice location 3

8881 M 119
Harbor Springs, MI 49740-9816
Phone (231) 487-2270

Other practice location 4

8605 Stoney Creek Dr
South Lyon, MI 48178-9490
Phone (734) 660-3411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250407002776 MI Practitioner - Physician Assistant 2365966744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Healthcare Charlevoix Hospital 57 clinicians
St Joseph Mercy Hospital 69 clinicians

Practice addresses (Care Compare)

14695 Park Ave
Suite a
Charlevoix, MI 49720-1920
Phone (231) 487-2270

5301 E Huron River Dr
Ann Arbor, MI 48197-1051
Phone (734) 712-3456

Hospital & facility affiliations

  • Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322
  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601012888MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Mercy Hospital CurrentSince Jan 17, 2025 Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Jan 17, 2025 Accepting new patients
St Joseph Mercy Hospital Physician Assistant CurrentSince Jan 17, 2025 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Past Accepting new patients
Munson Healthcare Charlevoix Hospital Past Accepting new patients

Locations

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

20555 Victor Pkwy
#3A
Livonia, MI 48152

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Interoperability endpoints

  • Direct secure messaging: jkapke4077737@direct.trinity-health.org

Organizations & group practices 15

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.

View all 15

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": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1679397640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14695 PARK AVE STE A",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201920",
            "telephone_number": "321-487-2270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1619 Anderson Rd",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497709256",
            "country_code": "US",
            "telephone_number": "231-417-6075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "829 N Center Ave Ste 260",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497351597",
            "country_code": "US",
            "telephone_number": "989-731-6405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8881 M 119",
            "address_purpose": "LOCATION",
            "city": "Harbor Springs",
            "state": "MI",
            "postal_code": "497409816",
            "country_code": "US",
            "telephone_number": "231-487-2270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8605 Stoney Creek Dr",
            "address_purpose": "LOCATION",
            "city": "South Lyon",
            "state": "MI",
            "postal_code": "481789490",
            "country_code": "US",
            "telephone_number": "734-660-3411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAPKE",
        "first_name": "JUSTIN",
        "middle_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-14",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

Verify at the official NPI Registry.