NPIMap

Individual provider Active NPI

Ty M Kwaiser, MD

  • Obstetrics & Gynecology Physician
  • Royal Oak, MI
National Provider Identifier
1922039742
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301061638 Issued in MI
Practice address
3535 W 13 Mile Rd
Ste 329
Royal Oak, MI 48073-6770
Phone
(248) 551-1399
Fax
(248) 551-5158
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301061638 MI Primary

Addresses

Primary practice location

3535 W 13 Mile Rd
Ste 329
Royal Oak, MI 48073-6770

Mailing address

3535 W 13 Mile Rd
Ste 329
Royal Oak, MI 48073-6770
Phone (248) 551-1399

Other identifiers 1

IdentifierTypeStateIssuer
431277710MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tkwaiser15151@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040306000081 MI Practitioner - Obstetrics/Gynecology 9739077397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wayne State University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William Beaumont HospitalGroup PAC ID 9335051093, 20 clinicians

Practice addresses (Care Compare)

26001 Jefferson Ave
Saint Clair Shores, MI 48081-2309
Phone (586) 779-7000

3535 W 13 Mile Rd
Royal Oak, MI 48073-6770

3535 W 13 Mile Rd LL
Cor HLTH Univ Hosp
Royal Oak, MI 48073-6770
Phone (248) 551-3000

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Merit-based Incentive Payment System (MIPS)

Final score
91.2 of 100Reported as group
Quality
87.94
Promoting interoperability
100
Improvement activities
40
Cost
63.73

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
William Beaumont Hospital Current Accepting new patients
Paint Creek Obstetrics & Gynecology PC Obstetrics & Gynecology Past Accepting new patients
William Beaumont Hospital Past Accepting new patients
William Beaumont Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tkwaiser292514@epic00.shdirect.org

Organizations & group practices 4

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 3

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1922039742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "address_2": "STE 329",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-551-1399",
            "fax_number": "248-551-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "address_2": "STE 329",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-551-1399",
            "fax_number": "248-551-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAISER",
        "first_name": "TY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301061638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431277710",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkwaiser15151@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3535 W 13 Mile Rd",
            "address_2": "Ste 329",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.