Individual provider Active NPI

Josephine M Kamendat, FNP -C

  • Family Nurse Practitioner
  • Fort Gratiot, MI
National Provider Identifier
1801387592
Registry record updated May 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704239237NSA18322 Issued in MI
Practice address
4071 24TH Ave
Fort Gratiot, MI 48059-3801
Phone
(810) 824-4222
NPI assigned
May 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704239237NSA18322 MI Primary

Addresses

Primary practice location

4071 24TH Ave
Fort Gratiot, MI 48059-3801

Mailing address

6141 State Rd
Burtchville, MI 48059-2420
Phone (810) 874-6116

Other practice location 1

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

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
I20180716001972 MI Practitioner - Nurse Practitioner 5092062547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Port HuronGroup PAC ID 9931018702, 48 clinicians

Practice addresses (Care Compare)

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704239237NSA18322MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Port Huron CurrentSince Jul 1, 2018 Accepting new patients
McLaren Port Huron Current Accepting new patients

Locations

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

1163 S Carney Dr
Saint Clair, MI 48079
Phone (810) 561-8450

Interoperability endpoints

  • Direct secure messaging: jkamendat1@direct-address.org

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": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1801387592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6141 STATE RD",
            "city": "BURTCHVILLE",
            "state": "MI",
            "postal_code": "480592420",
            "telephone_number": "810-874-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4071 24TH AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593801",
            "telephone_number": "810-824-4222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 Pine Grove Ave",
            "address_purpose": "LOCATION",
            "city": "Port Huron",
            "state": "MI",
            "postal_code": "480603511",
            "country_code": "US",
            "telephone_number": "810-987-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMENDAT",
        "first_name": "JOSEPHINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "FNP -C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704239237NSA18322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

Verify at the official NPI Registry.