Jennifer L Kozak, NPC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704191405 Issued in MI

Practice address

28963 Little Mack
Ste 101
St Clair Shores, MI 48081

Phone

(586) 447-0700

Fax

(586) 498-0707

NPI assigned

Jan 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Landry Other name

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

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
• Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146
• Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkozak250839@direct.hfhs.org

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.

• Henry Ford Health System

  • Nurse Practitioner
  • Detroit, MI
  • NPI 1104900455
  Medicare reassignment Care Compare group NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Henry Ford Maplegrove Center

  • Children's Substance Abuse Rehabilitation Facility
  • West Bloomfield, MI
  • NPI 1295767630
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Health System

  • General Acute Care Hospital
  • West Bloomfield, MI
  • NPI 1407867559
  Care Compare affiliation
• Henry Ford Wyandotte Hospital

  • Ambulatory Surgical Clinic/Center
  • Wyandotte, MI
  • NPI 1093901035

  Hospital

  Care Compare affiliation
• Henry Ford Wyandotte Hospital

  • General Acute Care Hospital
  • Wyandotte, MI
  • NPI 1992725352
  Care Compare affiliation

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1801866124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28963 LITTLE MACK",
            "address_2": "STE 101",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-447-0700",
            "fax_number": "586-498-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28963 LITTLE MACK",
            "address_2": "STE 101",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-447-0700",
            "fax_number": "586-498-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704191405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LANDRY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bhavesh Korat, P.T.
• Sarah Koslakiewicz, MD
• Marcus E Koss, M.D.
• Mohammad Kousha, M.D.
• Elona Koxhaj
• Christopher Richard Koziara, M.D.
• Desaray Ann Krahenbuhl, LLMSW
• Beverly Krall, OTR/L
• Neal M. Krasnick, M.D.
• William L. Krieg, D.D.S.,M.S.

• Family Nurse Practitioner in St Clair Shores, MI
• Providers in St Clair Shores, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.