Kelsey Blue Nusbaum, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301517943 Issued in MI

Practice address

5199 N Royal Dr
Traverse City, MI 49684-9201

Phone

(231) 486-0230

NPI assigned

May 4, 2022

Last updated

Oct 5, 2026By the provider in NPPES

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

Other names 1

• Kelsey Blue Keyser Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Dermatology

Education

Cincinnati College of Medicine and Surgery, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Ohio State University Wexner Medical Center

  • Student in an Organized Health Care Education/Training Program
  • Columbus, OH
  • NPI 1992598429
  NPD

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1912642851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5199 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849201",
            "telephone_number": "231-486-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5199 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849201",
            "telephone_number": "231-486-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSBAUM",
        "first_name": "KELSEY",
        "middle_name": "BLUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-04",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301517943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "KEYSER",
            "middle_name": "BLUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Trisha Ann Novak, LMSW
• Novello Imaging PLC
• Novello Specialty Clinic PC
• Nrmi, LLC (NeuroRestorative Michigan)
• Nula Nutrition LLC
• Mary Nussbaum
• Thomas C Nussdorfer, M.D.
• Noelle Gabrielle Nyquist
• Anya F Nyson, LMSW
• Abigail Marie O'Brien, FNP-C

• Dermatology Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; 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.