Individual provider Active NPI

Kate Deyoung Brune, D.O.

  • Neonatal-Perinatal Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1710327747
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
5101020441 Issued in MI
Practice address
1540 E Hospital Dr RM 8621
Ann Arbor, MI 48109-4000
Phone
(734) 763-4109
NPI assigned
Jul 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5101020441 MI
Neonatal-Perinatal Medicine Physician 2080N0001X 03946 KY
Neonatal-Perinatal Medicine Physician 2080N0001X 5101020441 MI Primary

Addresses

Primary practice location

1540 E Hospital Dr RM 8621
Ann Arbor, MI 48109-4000

Mailing address

24 Frank Lloyd Wright Dr Ste J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

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
I20180122001864 MI Practitioner - Pediatric Medicine 0749549673 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101020441MIMDPediatrics Physician
03946KYMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Jan 1, 2018 Accepting new patients
Henry Ford Health St. John Hospital Pediatrics CurrentSince Jan 1, 2018 Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22201 Moross Rd
Ste 70
Grosse Pointe, MI 48236
Phone (313) 343-3700

22201 Moross Rd
Ste 270
Grosse Pointe, MI 48236
Phone (313) 343-3481

17900 23 Mile Rd
Ste 101
Macomb, MI 48044
Phone (586) 868-9010

Interoperability endpoints

  • Direct secure messaging: kbrune1119233@direct.hfhs.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1710327747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR STE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E HOSPITAL DR RM 8621",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481094000",
            "telephone_number": "734-763-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNE",
        "first_name": "KATE",
        "middle_name": "DEYOUNG",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-05",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101020441",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "KY",
            "license": "03946",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MI",
            "license": "5101020441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.