Individual provider Active NPI

Kristin Hardecki, PA-C

  • Physician Assistant
  • Warren, MI
National Provider Identifier
1790588598
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601013494 Issued in MI
Practice address
31150 Hoover Rd Ste B
Warren, MI 48093-7618
Phone
(586) 983-3666
NPI assigned
Mar 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601013494 MI Primary

Addresses

Primary practice location

31150 Hoover Rd Ste B
Warren, MI 48093-7618

Mailing address

31150 Hoover Rd Ste B
Warren, MI 48093-7618
Phone (586) 983-3666

Other practice location 1

2799 W Grand Blvd
Detroit, MI 48202-2689
Phone (313) 916-2555

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
I20260213002000 MI Practitioner - Physician Assistant 5597245167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BG Tricounty Neurologyand Sleep Clinic PCGroup PAC ID 6709806714, 3 clinicians

Practice addresses (Care Compare)

31150 Hoover Rd B
Warren, MI 48093-7618
Phone (586) 983-3666

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601013494MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
BG Tricounty Neurology& Sleep Clinic PC CurrentSince Jan 1, 2026 Accepting new patients

Locations

31150 Hoover Rd
Ste B
Warren, MI 48093
Phone (586) 983-3666

Organizations & group practices 2

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 3

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": "1743120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1790588598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31150 HOOVER RD STE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480937618",
            "telephone_number": "586-983-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31150 HOOVER RD STE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480937618",
            "telephone_number": "586-983-3666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022689",
            "country_code": "US",
            "telephone_number": "313-916-2555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDECKI",
        "first_name": "KRISTIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-28",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601013494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.