NPIMap

Individual provider Active NPI

Kenneth Paul D'Andrea, D.O.

  • Neurological Surgery Physician
  • Detroit, MI
National Provider Identifier
1780951582
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
5101019577 Issued in MI
Practice address
22201 Moross Rd
Suite 352
Detroit, MI 48236-2169
Phone
(313) 343-7747
Fax
(313) 343-7001
NPI assigned
Nov 22, 2011
Last updated
May 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 5101019577 MI Primary

Addresses

Primary practice location

22201 Moross Rd
Suite 352
Detroit, MI 48236-2169

Mailing address

22201 Moross Rd
Suite 352
Detroit, MI 48236-2169
Phone (313) 343-7747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170522000038 MI Practitioner - Neurosurgery 7719254820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
New York College of Osteo Medicine of New York Institute of Technology, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161

22101 Moross Rd
Detroit, MI 48236-2148
Phone (586) 753-0011

22201 Moross Rd
Detroit, MI 48236-2176

46591 Romeo Plank Rd
Suite 137
Macomb, MI 48044-5743
Phone (586) 226-6269

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion84
Laminectomy or laminotomy (partial removal of spine bones)33
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Jul 1, 2017 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital Neurological Surgery CurrentSince Jul 1, 2017 Accepting new patients
Henry Ford Cornerstone Medical Group Current Accepting new patients
Henry Ford Health St. John Hospital Past Accepting new patients

Locations

42645 Garfield Rd
Ste 103
Clinton Twp, MI 48038
Phone (586) 286-0050

22201 Moross Rd
Ste 352
Grosse Pointe, MI 48236
Phone (313) 343-0088

22201 Moross Rd
Ste 380
Grosse Pointe Woods, MI 48236
Phone (313) 343-4437

17900 23 Mile Rd
Ste 303
Macomb, MI 48044
Phone (586) 868-9020

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/
  • Direct secure messaging: kdandrea1124431@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1780951582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD",
            "address_2": "SUITE 352",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362169",
            "telephone_number": "313-343-7747",
            "fax_number": "313-343-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD",
            "address_2": "SUITE 352",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362169",
            "telephone_number": "313-343-7747",
            "fax_number": "313-343-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANDREA",
        "first_name": "KENNETH",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-22",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "5101019577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.