Individual provider Active NPI

Kenneth D Kreitel, MD

  • Diagnostic Radiology Physician
  • Kalamazoo, MI
National Provider Identifier
1750503181
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301102231 Issued in MI
Practice address
1535 Gull Rd Ste 200
Kalamazoo, MI 49048
Phone
(269) 388-6350
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301102231 MI Primary

Addresses

Primary practice location

1535 Gull Rd Ste 200
Kalamazoo, MI 49048

Mailing address

1535 Gull Rd Ste 200
Kalamazoo, MI 49048-1638
Phone (269) 388-6350

Other practice location 1

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 388-6350

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
I20130816000133 MI Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2961644265 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Cincinnati College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Borgess HospitalGroup PAC ID 5294645750, 41 clinicians
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-5165

1541 Gull Rd
Kalamazoo, MI 49048-1644
Phone (269) 381-7380

7901 Angling Rd
Portage, MI 49024-0714

Hospital & facility affiliations

  • Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301102231MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Borgess Hospital Diagnostic Radiology CurrentSince May 28, 2023 Accepting new patients
Ascension Borgess Lee Hospital CurrentSince Jul 1, 2013 Accepting new patients
Promed Healthcare CurrentSince Aug 1, 2013 Accepting new patients
Ascension Borgess Lee Hospital Diagnostic Radiology CurrentSince Jul 1, 2013 Accepting new patients
Ascension Borgess Hospital CurrentSince May 28, 2023 Accepting new patients
Ascension Borgess Hospital Current Accepting new patients
Ascension Medical Group Promed CurrentSince Aug 1, 2013 Accepting new patients

Locations

3180 Solutions Ctr
Chicago, IL 60677

420 W High St
Dowagiac, MI 49047
Phone (269) 782-8681

1541 Gull Rd
Ste 200
Kalamazoo, MI 49048
Phone (269) 343-1264

1535 Gull Rd
Ste 200
Kalamazoo, MI 49048
Phone (269) 388-6350

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1750503181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 GULL RD STE 200",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481638",
            "telephone_number": "269-388-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 GULL RD STE 200",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49048",
            "telephone_number": "269-388-6350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1521 Gull Rd",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490481640",
            "country_code": "US",
            "telephone_number": "269-388-6350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KREITEL",
        "first_name": "KENNETH",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301102231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.