Individual provider Active NPI

Kelsey Rae Plambeck, MD

  • Student in an Organized Health Care Education/Training Program
  • Ypsilanti, MI
National Provider Identifier
1780528224
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4351055649 Issued in MI
Practice address
300 W Michigan Ave
Ypsilanti, MI 48197-5443
Phone
(734) 615-2690
NPI assigned
Apr 15, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351055649 MI Primary

Addresses

Primary practice location

300 W Michigan Ave
Ypsilanti, MI 48197-5443

Mailing address

300 N Ingalls St # Ni4C06
Ann Arbor, MI 48109-0400
Phone (734) 615-2690

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
I20260505003335 MI Order and Referring Only - Family PracticePractitioner - Family Practice 0749758043

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351055649MIMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1776211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1780528224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N INGALLS ST # NI4C06",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481090400",
            "telephone_number": "734-615-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MICHIGAN AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481975443",
            "telephone_number": "734-615-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLAMBECK",
        "first_name": "KELSEY",
        "middle_name": "RAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-15",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351055649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.