Organization Active NPI

Luana J Kyselka MD PC

  • Gynecology Physician
  • Troy, MI
National Provider Identifier
1962677104
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
LK043787 Issued in MI
Legal business name
LUANA J KYSELKA MD PC
Practice address
2877 Crooks Road
Suite D
Troy, MI 48084-4717
Phone
(248) 643-6634
Fax
(248) 643-7165
NPI assigned
Apr 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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

Authorized official

Name
Dr. Luana J Kyselka, MD
Title
President
Phone
(248) 643-6634

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X LK043787 MI Primary

Addresses

Primary practice location

2877 Crooks Road
Suite D
Troy, MI 48084-4717

Mailing address

2877 Crooks Rd
Suite D
Troy, MI 48084-4717
Phone (248) 643-6634

Other identifiers 1

IdentifierTypeStateIssuer
0630809OtherMIBCBSM

National Provider Directory

National Provider Directory

Locations

2877 Crooks Rd
Ste D
Troy, MI 48084
Phone (248) 643-0273

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1962677104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2877 CROOKS RD",
            "address_2": "SUITE D",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844717",
            "telephone_number": "248-643-6634",
            "fax_number": "248-643-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2877 CROOKS ROAD",
            "address_2": "SUITE D",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844717",
            "telephone_number": "248-643-6634",
            "fax_number": "248-643-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUANA J KYSELKA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "KYSELKA",
        "authorized_official_first_name": "LUANA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-643-6634",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MI",
            "license": "LK043787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0630809",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.