Ronald L Kissel, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301101860 Issued in MI

Practice address

423 Sycamore St Ste 103
Niles, MI 49120-2374

Phone

(269) 479-3030

Fax

(269) 479-3032

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Christian Global Medical Healthcare, Incorporated

  • Primary Care Clinic/Center
  • Portage, MI
  • NPI 1841621299
  Medicare reassignment NPD
• Integrated Home Doctors P.L.L.C.

  • Home Health Agency
  • Warren, MI
  • NPI 1114640273
  NPD Authorized official
• Christian Global Medical Healthcare Incorporated

  • Urgent Care Clinic/Center
  • Portage, MI
  • NPI 1063804995
  NPD
• Vitality Group Inc

  dba Vitality Health Services inc

  • Home Health Agency
  • Southfield, MI
  • NPI 1316194210
  NPD

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1851484356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 SYCAMORE ST STE 103",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202374",
            "telephone_number": "269-479-3030",
            "fax_number": "269-479-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 SYCAMORE ST STE 103",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202374",
            "telephone_number": "269-479-3030",
            "fax_number": "269-479-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSEL",
        "first_name": "RONALD",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301101860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Kato, LLMSW
• Kenneth Walter Kaufmann II, M.D.
• Melissa J Kennedy
• Lindsey Kathryn Kinney, DO
• Mary Jo Kirer, OTR/L
• Terrianne Klaeren
• Kevin Michael Klipowicz, PHARMD
• Stephanie Knight
• Dawn L Knuth, CCC-SLP
• Liudmila Komarova, COTA/L

• General Practice Physician in Niles, MI
• Providers in Niles, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.