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KATHLEEN D AMBROSE NP NPI 1407816143


NPI Information

NPI: 1407816143
Provider Name: KATHLEEN D AMBROSE, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
64580 VAN DYKE RD
SUITE C
WASHINGTON, MI
ZIP 48095
Phone: (586) 752-9629
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Kathleen D Ambrose, NP is a family nurse practitioner in Washington, MI. Kathleen D Ambrose, NP NPI is 1407816143. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

64580 VAN DYKE RD
SUITE C
WASHINGTON, MI
ZIP 48095-857
Phone: (586) 752-9629
Fax: (586) 752-4099

The NPI 1407816143 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Vaccine for influenza for injection into muscle (HCPCS:90662)
  • Administration of pneumococcal vaccine (HCPCS:G0009)
  • Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)
  • X-ray of chest, 2 views (HCPCS:71046)

The enumeration date for this NPI number is 3/25/2006 and was last updated on 2/1/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WG0000XRegistered NurseGeneral Practice470413564MICHIGANNo
2363LF0000XNurse PractitionerFamily4704131564MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
150-0866503-0OTHERMICHIGANBCBS PIN NUMBER
2S85620MEDICARE UPINMICHIGAN
34378376MEDICAIDMARYLAND
4N40180-001MEDICARE ID-TYPE UNSPECIFIEDMICHIGANMEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.