Individual provider Active NPI

Alexis Olivia Kashat, FNP-C

  • Family Nurse Practitioner
  • Beverly Hills, MI
National Provider Identifier
1972109288
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704335405 Issued in MI
Practice address
31333 Southfield Rd Ste 130
Beverly Hills, MI 48025-5412
Phone
(248) 952-9190
NPI assigned
Dec 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704335405 MI Primary

Addresses

Primary practice location

31333 Southfield Rd Ste 130
Beverly Hills, MI 48025-5412

Mailing address

31333 Southfield Rd Ste 130
Beverly Hills, MI 48025-5412
Phone (248) 952-9190

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211115002512 MI Practitioner - Nurse Practitioner 5193114080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dearborn Physical Therapy LTD 97 clinicians
Affiliated Knee Pain Specialists PLLC 7 clinicians

Practice addresses (Care Compare)

23852 Michigan Ave
Dearborn, MI 48124-1829

45445 Mound Rd
Suite 105
Shelby Township, MI 48317-5178
Phone (866) 207-5105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704335405MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Knee Pain Specialists PLLC CurrentSince Oct 1, 2021 Accepting new patients
Affiliated Knee Pain Specialists, PLLC CurrentSince Oct 1, 2021 Accepting new patients
Affiliated Knee Pain Specialists PLLC PastSince Feb 13, 2022 Accepting new patients

Locations

31333 Southfield Rd
Ste 130
Beverly Hills, MI 48025
Phone (248) 952-9190

31333 Southfield Rd
Ste 103
Beverly Hills, MI 48025
Phone (248) 952-9190

8565 N Silvery Ln
Ste 405
Dearborn Heights, MI 48127
Phone (313) 512-7111

8565 N Silvery Ln
Ste 402
Dearborn Heights, MI 48127
Phone (313) 512-7111

8565 N Silvery Ln
#405
Dearborn Heights, MI 48127

2503 S Linden Rd
Ste 120
Flint, MI 48532
Phone (313) 512-7111

45445 Mound Rd
Ste 105
Shelby Township, MI 48317
Phone (248) 952-9190

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1972109288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31333 SOUTHFIELD RD STE 130",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255412",
            "telephone_number": "248-952-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31333 SOUTHFIELD RD STE 130",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255412",
            "telephone_number": "248-952-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHAT",
        "first_name": "ALEXIS",
        "middle_name": "OLIVIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704335405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, MI

Sources for this page

Verify at the official NPI Registry.