Individual provider Active NPI

Kaydi Lentz, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1831649110
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020132 Issued in NY
Practice address
1955 1St Ave
Apt 527
New York, NY 10029-6408
Phone
(407) 451-1738
NPI assigned
Oct 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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 020132 NY Primary

Addresses

Primary practice location

1955 1St Ave
Apt 527
New York, NY 10029-6408

Mailing address

1467 Chesapeake
Royal Oak, MI 48067-4526
Phone (407) 451-1738

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
I20190814003599 MI Practitioner - Physician Assistant 7719266022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Center for Dermatology and Pathology PLLCGroup PAC ID 0446330492, 49 clinicians

Practice addresses (Care Compare)

28333 Harper Ave
Saint Clair Shores, MI 48081-1687
Phone (586) 776-9770

31275 Northwestern Hwy
Suite 140
Farmington Hills, MI 48334-2531
Phone (248) 538-0109

43900 Garfield Rd
Clinton Township, MI 48038-1137
Phone (586) 286-0112

5701 Bow Pointe Dr
Suite 215
Clarkston, MI 48346-5400
Phone (248) 236-5040

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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 1

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": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563840000000",
    "number": "1831649110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1467 CHESAPEAKE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480674526",
            "telephone_number": "407-451-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 1ST AVE",
            "address_2": "APT 527",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296408",
            "telephone_number": "407-451-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENTZ",
        "first_name": "KAYDI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2019-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.