Kaitlin Marie Seryak, M.S., M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301500870 Issued in MI

Practice address

2331 Monroe St
Dearborn, MI 48124-3009

Phone

(313) 792-0346

NPI assigned

Apr 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, OH2 enrollments

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 2

Specialty

General Practice

Education

Wayne State University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patheous Medical PLLCGroup PAC ID 8921458720, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kseryak194716@direct.hfhs.org

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.

• Patheous Medical PLLC

  • Diagnostic Radiology Physician
  • Leawood, KS
  • NPI 1366121527

  MI, OH

  Medicare reassignment Care Compare group NPD
• Ypsilanti Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Ypsilanti, MI
  • NPI 1881048494
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment NPD
• Farmington Hills Urgent Care Walk-in Clinic PC

  • Urgent Care Clinic/Center
  • Farmington Hills, MI
  • NPI 1144956350
  NPD (past)
• M Natacha Umlauf MD Pediatrics PLC

  • Public Health & General Preventive Medicine Physician
  • Dearborn, MI
  • NPI 1750354692
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1699139733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243009",
            "telephone_number": "313-792-0345",
            "fax_number": "313-792-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243009",
            "telephone_number": "313-792-0346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14671 Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Redford",
            "state": "MI",
            "postal_code": "482393300",
            "country_code": "US",
            "telephone_number": "313-729-8624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3990 John R St",
            "address_2": "Suite 615",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012018",
            "country_code": "US",
            "telephone_number": "313-745-4195",
            "fax_number": "313-993-8669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERYAK",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301500870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kaitlin.seryak@dearbornpediatrics.com",
            "affiliation": "N",
            "endpointDescription": "professional work email",
            "address_1": "2331 Monroe St",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481243009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Serenity Step LLC
• Lana Hassan Serhan
• Samantha Sermack
• Nicholas Nathan Serocki, CGC
• Services to Enhance Potential
• Ebonique Monet Sewell
• Chelsie Nicole Sexton
• Janina Seychel
• Helayna L Shackelford
• Lori Shaffer, M.A.,CCC-SLP.

• General Practice Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.