NPIMap

Organization Active NPI

Affiliated Knee Pain Specialists, PLLC

Doing business as Nu Life Medical

  • Internal Medicine Physician
  • Beverly Hills, MI
National Provider Identifier
1699262006
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301070138 Issued in MI
Legal business name
AFFILIATED KNEE PAIN SPECIALISTS, PLLC
Doing business as
Nu Life Medical
Practice address
31333 Southfield Rd Ste 103
Beverly Hills, MI 48025-5473
Phone
(248) 952-9190
Fax
(248) 952-9190
NPI assigned
Apr 20, 2018
Last updated
Jan 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Authorized official

Name
Steve Z. Kallabat, MDNPI 1245291475
Title
Owner/Medical Doctor
Phone
(928) 445-7085

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 4301070138 MI Primary

Addresses

Primary practice location

31333 Southfield Rd Ste 103
Beverly Hills, MI 48025-5473

Mailing address

45445 Mound Rd Ste 105
Shelby Township, MI 48317-5178
Phone (866) 207-5105

Other practice location 1

45445 Mound Rd Ste 105
Shelby Township, MI 48317-5178
Phone (866) 207-5105

Other names 1

  • Nu Life Medical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180625002002 MI Part B Supplier - Clinic/Group Practice 4587919055 Receives reassigned benefits from 9 practitioners
Practice locations: Dearborn Heights, MI; Flint, MI; Shelby Township, MI
O20180920003506 MI DME Supplier - Physician - Internal Medicine 4587919055 Practice locations: Beverly Hills, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Affiliated Knee Pain PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

31333 Southfield Rd
Ste 103
Beverly Hills, MI 48025
Phone (248) 952-9190

211 Hamilton Row
Birmingham, MI 48009
Phone (928) 445-7085

8565 N Silvery Ln
#405
Dearborn Heights, MI 48127

8565 N Silvery Ln
Ste 402
Dearborn Heights, MI 48127
Phone (313) 512-7111

45445 Mound Rd
Ste 105
Shelby Township, MI 48317
Phone (248) 952-9190

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1699262006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45445 MOUND RD STE 105",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483175178",
            "telephone_number": "866-207-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31333 SOUTHFIELD RD STE 103",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255473",
            "telephone_number": "248-952-9190",
            "fax_number": "248-952-9190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45445 Mound Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Shelby Township",
            "state": "MI",
            "postal_code": "483175178",
            "country_code": "US",
            "telephone_number": "866-207-5105",
            "fax_number": "248-282-1313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AFFILIATED KNEE PAIN SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-20",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "KALLABAT",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "Z.",
        "authorized_official_title_or_position": "OWNER/MEDICAL DOCTOR",
        "authorized_official_telephone_number": "928-445-7085",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301070138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nu Life Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beverly Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.