Individual provider Active NPI

Katharina E Elliott

  • Pediatric Hematology & Oncology Physician
  • Kalamazoo, MI
National Provider Identifier
1710956347
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
4301072976 Issued in MI
Practice address
601 John St
Suite M005
Kalamazoo, MI 49007-5341
Phone
(269) 341-6350
Fax
(269) 341-8580
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X 4301072976 MI Primary

Addresses

Primary practice location

601 John St
Suite M005
Kalamazoo, MI 49007-5341

Mailing address

601 John St
Suite M005
Kalamazoo, MI 49007-5341
Phone (269) 341-6350

Other identifiers 4

IdentifierTypeStateIssuer
1710956347MedicaidMI
3503904111OtherBCBS
4186840MedicaidMI
1417961137OtherMIBCBSM - BRONSON

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

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
I20041130000858 MI Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 0749245892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Pediatric Medicine
Education
New York Medical College, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

601 John St
Suite 005
Kalamazoo, MI 49007-5381
Phone (269) 341-6350

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Dec 15, 2011 Accepting new patients
Bronson Methodist Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Western Michigan University School of Medicine Past Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Past Accepting new patients

Locations

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
Ste M-425
Kalamazoo, MI 49007
Phone (269) 341-7909

601 John St
Ste M-005
Kalamazoo, MI 49007
Phone (269) 341-6350

Interoperability endpoints

  • Direct secure messaging: kelliott10455@direct.bronsonhg.org
  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 5

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1710956347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE M005",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-6350",
            "fax_number": "269-341-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE M005",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-6350",
            "fax_number": "269-341-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KATHARINA",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MI",
            "license": "4301072976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710956347",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3503904111",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4186840",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM - BRONSON",
            "identifier": "1417961137",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.