Kristi A Tesarz, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004922 Issued in MI

Practice address

26206 W 12 Mile Rd Ste 202
Southfield, MI 48034-8500

Phone

(248) 827-7612

Fax

(248) 827-7615

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Downriver Internal Medicine, PC

  • Internal Medicine Physician
  • Riverview, MI
  • NPI 1417160698
  Medicare reassignment

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1740367036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1544 OLD BRIDGE CT",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481881241",
            "telephone_number": "734-394-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26206 W 12 MILE RD STE 202",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480348500",
            "telephone_number": "248-827-7612",
            "fax_number": "248-827-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESARZ",
        "first_name": "KRISTI",
        "middle_name": "A",
        "credential": "PA C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anabel Teran, RN
• Marc Stuart Terebelo, D.C.
• Paula Terenzi, DPT
• Robin Renee Terrell
• Stephon Terrell
• Martin Edward Tessler, MD
• Test Pro Labs
• Tewodros Fesseha, M.D., P.C.
• Sissay Tezera, D.C.
• Harsh Anish Thacker

• Physician Assistant in Southfield, MI
• Providers in Southfield, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.