Individual provider Active NPI

Anne L Kittendorf, MD

  • Family Medicine Physician
  • Dexter, MI
National Provider Identifier
1679661672
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301078373 Issued in MI
Practice address
7300 Dexter-Ann Arbor Rd
Dexter, MI 48130-8598
Phone
(734) 426-2796
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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 4301078373 MI Primary

Addresses

Primary practice location

7300 Dexter-Ann Arbor Rd
Dexter, MI 48130-8598

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
4648373MedicaidMI

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
I20041104000525 MI Practitioner - Family Practice 0749243483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

14700 E Old US Hwy 12
Chelsea, MI 48118-1185
Phone (734) 539-5000

7300 Dexter Ann Arbor Rd
Dexter, MI 48130-8598
Phone (734) 539-5000

Hospital & facility affiliations

  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan CurrentSince Sep 28, 2004 Accepting new patients
Regents of the University of Michigan Family Medicine CurrentSince Sep 28, 2004 Accepting new patients

Locations

4260 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 647-5715

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

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

3621 S State St
#700
Ann Arbor, MI 48108

14700 E Old US Highway 12
Chelsea, MI 48118
Phone (734) 475-1321

7300 Dexter Ann Arbor Rd
Dexter, MI 48130
Phone (734) 426-2796

200 Arnet St
Ste 200
Ypsilanti, MI 48198
Phone (734) 482-6221

Interoperability endpoints

  • Direct secure messaging: akittendorf24884@direct.med.umich.edu

Organizations & group practices 2

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 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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1679661672",
    "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": "7300 DEXTER-ANN ARBOR RD",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481308598",
            "telephone_number": "734-426-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTENDORF",
        "first_name": "ANNE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301078373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4648373",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dexter, MI

Sources for this page

Verify at the official NPI Registry.