Vanessa Kondziolka, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704244257 Issued in MI

Practice address

16800 24 Mile Rd
Suite 4
Macomb, MI 48042-2990

Phone

(586) 992-9970

Fax

(586) 992-9972

NPI assigned

Mar 27, 2009

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

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kenwood Allergy and Asthma Center, P.C.Group PAC ID 9931202298, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Kenwood Allergy & Asthma Center, P.C.

  • Medical Specialty Clinic/Center
  • Chesterfield, MI
  • NPI 1508850777
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1871735563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 24 MILE RD",
            "address_2": "SUITE 4",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480422990",
            "telephone_number": "586-992-9970",
            "fax_number": "586-992-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16800 24 MILE RD",
            "address_2": "SUITE 4",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480422990",
            "telephone_number": "586-992-9970",
            "fax_number": "586-992-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDZIOLKA",
        "first_name": "VANESSA",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-27",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704244257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica D Kluz, NBC-HWC
• Aaron Kobernick, MD
• David Kola
• David M Kolakowski, DDS
• Monica Kolevski
• Amy Kopp, M.D.
• Samuel Korbel
• Daniel Ghassan Kosho, PHARM.D
• Carter Kovalcik, PT
• Maximilian Kowalski

• Family Nurse Practitioner in Macomb, MI
• Providers in Macomb, 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 Mar 27, 2009; 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.