NPIMap

Individual provider Active NPI

Anthony V Kamerschen, MD

  • Family Medicine Physician
  • Escanaba, MI
National Provider Identifier
1720213259
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301094554 Issued in MI
Practice address
3409 Ludington St
Suite 104
Escanaba, MI 49829-4212
Phone
(906) 786-8343
Fax
(906) 789-4430
NPI assigned
May 28, 2009
Last updated
Nov 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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 4301094554 MI Primary

Addresses

Primary practice location

3409 Ludington St
Suite 104
Escanaba, MI 49829-4212

Mailing address

3409 Ludington Street
Suite 104
Escanaba, MI 49829
Phone (906) 786-8343

Other identifiers 1

IdentifierTypeStateIssuer
1720213259MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121002000230 MI Practitioner - Family Practice 1355590654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis HospitalGroup PAC ID 5991604753, 85 clinicians

Practice addresses (Care Compare)

3409 Ludington St
Escanaba, MI 49829-4213

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Hospital Current Accepting new patients
St. Francis Hospital Family Medicine CurrentSince Aug 1, 2012 Accepting new patients
St Francis Hospital CurrentSince Aug 1, 2012 Accepting new patients
St Francis Hospital Past Accepting new patients

Locations

3409 Ludington St
Ste 104
Escanaba, MI 49829
Phone (906) 786-8343

126 S 25th St
#B
Escanaba, MI 49829
Phone (906) 233-9500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1720213259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 LUDINGTON STREET",
            "address_2": "SUITE 104",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "49829",
            "telephone_number": "906-786-8343",
            "fax_number": "906-789-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 LUDINGTON ST",
            "address_2": "SUITE 104",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498294212",
            "telephone_number": "906-786-8343",
            "fax_number": "906-789-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMERSCHEN",
        "first_name": "ANTHONY",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-28",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301094554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720213259",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

Verify at the official NPI Registry.