Kaitlyn Mackenzie Shaw

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

2550 S Telegraph Rd Ste 104
Bloomfield Hills, MI 48302-0951

Phone

(248) 972-5143

NPI assigned

May 29, 2024

Last updated

Mar 5, 2026By 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 names 1

• Kaitlyn Mackenzie Davidson Other name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Michigan Medical School, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Cosmetic Center PLLCGroup PAC ID 0244600807, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00340

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.

• Dermatology & Cosmetic Center PLLC

  • Dermatology Physician
  • Flint, MI
  • NPI 1811605660
  Medicare reassignment Care Compare group NPD
• Dermatology & Cosmetic Center of Bloomfield Hills PLLC

  • Dermatology Physician
  • Bloomfield Hills, MI
  • NPI 1073479945
  NPD (past)

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1952141863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 S TELEGRAPH RD STE 104",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 S TELEGRAPH RD STE 104",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020951",
            "telephone_number": "248-972-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KAITLYN",
        "middle_name": "MACKENZIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "DAVIDSON",
            "middle_name": "MACKENZIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Abul Shamsuddoha, M.D.
• Jeffrey Allan Sharbaugh, RPH
• Hanadi Sharfo
• Shari Dobrusin PH.D.
• Vinod Sharma, MD
• Brittney Rashaun Shegog, LCSW
• Mariko Kita Shelton, M.D.
• Ziqian Shen
• Jason Sherbel, DDS
• Mary Catherine Sherbel, DDS

• Physician Assistant in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Physician Assistant in Michigan

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