Khristine C Botezan, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301084929 Issued in MI

Practice address

150 N Delaware St
Sandusky, MI 48471-1009

Phone

(810) 648-9670

Fax

(810) 648-9677

NPI assigned

May 28, 2006

Last updated

Oct 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

General Surgery

Education

Yale University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Munson Healthcare GraylingGroup PAC ID 2062736655, 64 clinicians

St Francis HospitalGroup PAC ID 5991604753, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf St Francis Hospital and Medical Group Hospital, Escanaba, MI, CCN 231337
• Munson Healthcare Grayling Hospital Hospital, Grayling, MI, CCN 230058

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

• Munson Healthcare Grayling

  dba Roscommon Community Health Center

  • Rural Health Clinic/Center
  • Roscommon, MI
  • NPI 1710383351
  Medicare reassignment Care Compare group NPD
• St. Francis Hospital

  dba OFSMG - Women's Center

  • Obstetrics & Gynecology Physician
  • Escanaba, MI
  • NPI 1700828837
  Medicare reassignment Care Compare group
• Munson Healthcare Otsego Memorial Hospital

  dba Munson Healthcare OMH Medical Group-Gaylord RHC

  • Rural Health Clinic/Center
  • Gaylord, MI
  • NPI 1164628426
  Medicare reassignment NPD
• Portage Physician Practices Inc

  • Internal Medicine Physician
  • Hancock, MI
  • NPI 1225461684
  Medicare reassignment NPD
• Sandusky Surgical PLLC

  • Clinic/Center
  • Sandusky, MI
  • NPI 1093762742
  Authorized official Same address or phone
• Munson Healthcare Grayling

  dba Grayling Community Health Center

  • Rural Health Clinic/Center
  • Grayling, MI
  • NPI 1891191698
  NPD
• Munson Healthcare Otsego Memorial Hospital

  dba MHC Great Lakes Plastic Surgery & Skin Center- Petoskey

  • Plastic Surgery Physician
  • Petoskey, MI
  • NPI 1770374530
  NPD
• Portage Physician Practices Inc

  dba UP Medical Group - Portage Express Care

  • Rural Health Clinic/Center
  • Calumet, MI
  • NPI 1164106910
  NPD
• St Francis Hospital

  dba St. Francis Professional Services

  • Anatomic Pathology & Clinical Pathology Physician
  • Escanaba, MI
  • NPI 1932206455
  NPD
• St. Francis Hospital

  dba OSFMG Escanaba Gladstone Powers

  • Family Medicine Physician
  • Escanaba, MI
  • NPI 1629011622

  Surgery

  NPD
• McKenzie Memorial Hospital

  dba Peck Medical Center

  • Rural Health Clinic/Center
  • Peck, MI
  • NPI 1437917598
  NPD (past)
• Surgical Institute of South Dakota, PC

  dba Surgical Institute

  • Surgery Physician
  • Sioux Falls, SD
  • NPI 1760569248
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Healthcare Grayling

  • Rural Acute Care Hospital
  • Grayling, MI
  • NPI 1083010953
  Care Compare affiliation
• St Francis Hospital

  dba OSF Healthcare St. Francis Hospital & Medical Group

  • Critical Access Hospital
  • Escanaba, MI
  • NPI 1922058551
  Care Compare affiliation

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1912954652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484710191",
            "telephone_number": "810-648-9670",
            "fax_number": "810-648-9677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N DELAWARE ST",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711009",
            "telephone_number": "810-648-9670",
            "fax_number": "810-648-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTEZAN",
        "first_name": "KHRISTINE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301084929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4700615",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbotezan@direct.mhc.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1100 E Michigan Ave",
            "city": "Grayling",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497381312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bio-Medical Applications of Michigan, Inc. (Fresenius Medical Care Sandusky)
• Patricia Ann Black, RN
• Abigail Bolsby
• Renee Angeline Bolsby
• Teressa Bonesteel
• Abbey Bowerman
• Robert Elliott Boyle, DDS
• Chelsea Brinker
• Sandra Anne Brooks, MSW
• Janice Brown

• Surgery Physician in Sandusky, MI
• Providers in Sandusky, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.