Individual provider Active NPI

Kendra Khan

  • Family Nurse Practitioner
  • Macomb, MI
National Provider Identifier
1730714262
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704288367 Issued in MI
Practice address
47340 Savannah Dr
Macomb, MI 48044-2795
Phone
(248) 302-7417
NPI assigned
Mar 4, 2020
Last updated
Mar 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704288367 MI Primary

Addresses

Primary practice location

47340 Savannah Dr
Macomb, MI 48044-2795

Mailing address

47340 Savannah Dr
Macomb, MI 48044-2795
Phone (248) 302-7417

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200623003011 MI Practitioner - Nurse Practitioner 5092137927 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palliative Coach MichiganGroup PAC ID 4284085325, 2 clinicians
Applebaum Physiatry PLLCGroup PAC ID 8729453436, 141 clinicians

Practice addresses (Care Compare)

24889 Beach Dr
Macomb, MI 48042-4558
Phone (586) 420-1117

38410 Cherry Hill Rd
Westland, MI 48185-3270
Phone (734) 326-1200

Merit-based Incentive Payment System (MIPS)

Final score
91.72 of 100Reported as group
Quality
66.48
Improvement activities
40
Cost
83.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704288367MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palliative Coach Michigan CurrentSince Mar 10, 2026 Accepting new patients
Applebaum Physiatry PLLC Family CurrentSince Oct 31, 2023 Accepting new patients
Seasons Medical Group of Michigan, PC CurrentSince Jun 1, 2020 Accepting new patients

Locations

6400 Shafer Ct
Ste 700
Rosemont, IL 60018

128 S East St
Unit 1109
Crown Point, IN 46308

2975 N Adams Rd
Bloomfld Hls, MI 48304
Phone (248) 645-2900

2520 Lake Michigan Dr NW
Grand Rapids, MI 49504
Phone (616) 735-4541

27355 John R Rd
Madison Hts, MI 48071
Phone (248) 291-2698

1061 W Hackley Ave
Muskegon, MI 49441
Phone (231) 755-2255

38410 Cherry Hill Rd
Westland, MI 48185
Phone (734) 326-1200

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

NPI Registry JSON

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1730714262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47340 SAVANNAH DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480442795",
            "telephone_number": "248-302-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47340 SAVANNAH DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480442795",
            "telephone_number": "248-302-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "KENDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704288367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

Verify at the official NPI Registry.