Individual provider Active NPI

Kerrie Machcinski, NP-C

  • Nurse Practitioner
  • Romulus, MI
National Provider Identifier
1760909857
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704231734 Issued in MI
Practice address
16245 Hillsbriar Dr
Romulus, MI 48174-2982
Phone
(734) 637-6794
NPI assigned
Aug 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704231734 MI Primary

Addresses

Primary practice location

16245 Hillsbriar Dr
Romulus, MI 48174-2982

Mailing address

16245 Hillsbriar Dr
Romulus, MI 48174-2982
Phone (734) 637-6794

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
I20190521003360 MI Practitioner - Nurse Practitioner 9335482066 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyandotte Urgent Care ClinicGroup PAC ID 4183996150, 17 clinicians
Southshore Urgent Care PLLCGroup PAC ID 5698009777, 14 clinicians

Practice addresses (Care Compare)

1768 Ford Ave
Wyandotte, MI 48192-2306
Phone (313) 377-5758

20789 Gibraltar Rd
Brownstown TWP, MI 48183-5087
Phone (734) 444-2961

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wyandotte Urgent Care Clinic CurrentSince Apr 22, 2019 Accepting new patients
Blue Water Urgent Care PLLC Nurse Practitioner CurrentSince Jul 1, 2026 Accepting new patients
Southshore Urgent Care PLLC. CurrentSince Jul 1, 2019 Accepting new patients

Locations

20789 Gibraltar Rd
Brownstown Twp, MI 48183
Phone (734) 444-2961

1768 Ford Ave
Wyandotte, MI 48192
Phone (313) 377-5758

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": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760909857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16245 HILLSBRIAR DR",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481742982",
            "telephone_number": "734-637-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16245 HILLSBRIAR DR",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481742982",
            "telephone_number": "734-637-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHCINSKI",
        "first_name": "KERRIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704231734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Romulus, MI

Sources for this page

Verify at the official NPI Registry.