Individual provider Active NPI

Veronica Kwiatkowski, M.D.

  • Pediatrics Physician
  • Detroit, MI
National Provider Identifier
1730633090
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301503846 Issued in MI
Practice address
3901 Beaubien St
Detroit, MI 48201-2119
Phone
(313) 745-5870
NPI assigned
Aug 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301503846 MI Primary

Addresses

Primary practice location

3901 Beaubien St
Detroit, MI 48201-2119

Mailing address

U of R Medical Center, 601 Elmwood Avenue
Pediatric Residency Program
Rochester, NY 14642
Phone (585) 275-6918

Other practice location 1

U Of R Medical Center 601 Elmwood Ave
Pediatric Residency Program
Rochester, NY 14642-0001
Phone (585) 275-6918

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
I20231204001370 MI Practitioner - Pediatric Medicine 9032452131 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians Pediatrics CurrentSince Oct 30, 2023 Accepting new patients
University Pediatricians Pediatrics CurrentSince Oct 30, 2023 Accepting new patients
University Physician Group Past Accepting new patients

Locations

3901 Beaubien St
Ste H
Detroit, MI 48201
Phone (313) 745-5437

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

3950 Beaubien St
Fl 4
Detroit, MI 48201
Phone (313) 832-9220

Interoperability endpoints

  • Direct secure messaging: vkwiatkowski102962@direct.urmc.rochester.edu

Organizations & group practices 3

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": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1730633090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "U OF R MEDICAL CENTER, 601 ELMWOOD AVENUE",
            "address_2": "PEDIATRIC RESIDENCY PROGRAM",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14642",
            "telephone_number": "585-275-6918",
            "fax_number": "585-442-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012119",
            "telephone_number": "313-745-5870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "U Of R Medical Center 601 Elmwood Ave",
            "address_2": "Pediatric Residency Program",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146420001",
            "country_code": "US",
            "telephone_number": "585-275-6918",
            "fax_number": "585-442-6580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWIATKOWSKI",
        "first_name": "VERONICA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301503846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.