Individual provider Active NPI

Kathleen C Moltz, MD

  • Pediatric Endocrinology Physician
  • Detroit, MI
National Provider Identifier
1891733523
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
4301056341 Issued in MI
Practice address
3950 Beaubien
Children'S Hospital of Mi - Pediatric Endocrinology
Detroit, MI 48201
Phone
(313) 832-9221
NPI assigned
Jun 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301056341 MI
Pediatric Endocrinology Physician 2080P0205X 35128547 OH
Pediatric Endocrinology Physician 2080P0205X 4301056341 MI Primary

Addresses

Primary practice location

3950 Beaubien
Children'S Hospital of Mi - Pediatric Endocrinology
Detroit, MI 48201

Mailing address

1 Seagate
Ste 800
Toledo, OH 43604-1558
Phone (567) 585-1964

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmoltz47401@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050310000886 MI Practitioner - EndocrinologyPractitioner - Pediatric Medicine 2668426719 Reassigns benefits to 1 organization
I20160603001495 OH Practitioner - Endocrinology 2668426719 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Michigan State University College of Human Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Children'S SpecialistsGroup PAC ID 6709975345, 16 clinicians

Practice addresses (Care Compare)

2100 W Central Ave
Suite 100
Toledo, OH 43606-3817
Phone (419) 537-5111

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301056341MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Toledo Hospital CurrentSince Jun 1, 2016 Accepting new patients
The Toledo Hospital Pediatrics CurrentSince Jun 1, 2016 Accepting new patients
University Pediatricians Pediatrics CurrentSince Feb 16, 2010 Accepting new patients
Promedica Children'S Specialists Pediatrics CurrentSince Jun 1, 2021 Accepting new patients
University Pediatricians Pediatrics CurrentSince Feb 16, 2010 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3950 Beaubien St
Detroit, MI 48201
Phone (313) 745-5437

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

2100 W Central Ave
Ste 100A
Toledo, OH 43606
Phone (419) 291-8400

2121 Hughes Dr
Ste 220
Toledo, OH 43606
Phone (419) 291-7403

2100 W Central Ave
Ste 100
Toledo, OH 43606
Phone (419) 537-5111

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

1 Seagate
Ste 800
Toledo, OH 43604

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

Organizations & group practices 6

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 2

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1891733523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE",
            "address_2": "STE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "567-585-1964",
            "fax_number": "419-824-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 BEAUBIEN",
            "address_2": "CHILDREN'S HOSPITAL OF MI - PEDIATRIC ENDOCRINOLOGY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-832-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLTZ",
        "first_name": "KATHLEEN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301056341",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "OH",
            "license": "35128547",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MI",
            "license": "4301056341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmoltz47401@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.