Individual provider Active NPI

Ryan Korlewitz, DO

  • Surgery Physician
  • Pontiac, MI
National Provider Identifier
1922747039
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5151015904 Issued in MI
Practice address
44405 Woodward Ave
Pontiac, MI 48341-5023
Phone
(248) 858-3000
NPI assigned
May 27, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5151015904 MI Primary

Addresses

Primary practice location

44405 Woodward Ave
Pontiac, MI 48341-5023

Mailing address

7811 Spring Point CT NE
Rockford, MI 49341-8405
Phone (616) 430-2833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5151015904MIMDSurgery Physician

Interoperability endpoints

  • Direct secure messaging: rkorlewitz1847768@direct.trinity-health.org

NPI Registry JSON

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1922747039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7811 SPRING POINT CT NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493418405",
            "telephone_number": "616-430-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORLEWITZ",
        "first_name": "RYAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5151015904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.