Individual provider Active NPI

Krystine Marie Muha, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Macomb, MI
National Provider Identifier
1841870235
Registry record updated Apr 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704208498 Issued in MI
Practice address
50339 Margaret Ave
Macomb, MI 48044-6340
Phone
(586) 690-9607
NPI assigned
Apr 10, 2021
Last updated
Apr 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704208498 MI Primary

Addresses

Primary practice location

50339 Margaret Ave
Macomb, MI 48044-6340

Mailing address

15855 19 Mile Rd
Clinton TWP, MI 48038-3504
Phone (586) 263-2300

Other practice location 1

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kmuha1@hfhs.org Health Information Exchange (HIE) Henry Ford Hospital

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
I20211217001822 MI Practitioner - Nurse Practitioner 9739570102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

24715 Little Mack Ave
Suite 200
Saint Clair Shores, MI 48080-3207
Phone (586) 777-9000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704208498MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baddigam Family Psychiatric Associates PLLC CurrentSince Nov 1, 2021 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Aug 1, 2022 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Aug 1, 2022 Accepting new patients

Locations

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2373

43211 Dalcoma Dr
Ste 3
Clinton Twp, MI 48038
Phone (586) 263-6812

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

24715 Little Mack Ave
Ste 200
St Clr Shores, MI 48080
Phone (586) 777-9000

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

Interoperability endpoints

  • Direct secure messaging: kmuha1@hfhs.org
  • Direct secure messaging: lifestancehealth.krystinemuha@150339.advancedmd-direct.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618012800000",
    "number": "1841870235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50339 MARGARET AVE",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480446340",
            "telephone_number": "586-690-9607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15855 19 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480383504",
            "country_code": "US",
            "telephone_number": "586-263-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUHA",
        "first_name": "KRYSTINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-10",
        "last_updated": "2021-04-10",
        "certification_date": "2021-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704208498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kmuha1@hfhs.org",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Henry Ford Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "50339 Margaret Ave",
            "city": "Macomb",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480446340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

Verify at the official NPI Registry.