KEVIN KALISZEWSKI (NPI# 1760470488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760470488 |
| Entity Type | Individual |
| Full Name | KEVIN KALISZEWSKI |
| Credential | PA-C |
| Practice Address |
110 Beech St Suite B Tawas City MI 48763-8314 |
| Mailing Address |
Po Box 779 Tawas City MI 48764-0779 |
| Practice Telephone | 9893621015 |
| Practice Fax Number | 9893629862 |
| Mailing Telephone | 9893629411 |
| Mailing Fax Number | 9893629925 |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2019-10-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601003895 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3370220 | 05 |
| Street Address |
110 BEECH ST SUITE B |
| City | TAWAS CITY |
| State | MI |
| Zip Code | 48763-8314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699092379 | Diagnostic Pain and Rehab Medicine, Pllc | Clinic/Center | 110 Beech St, Suite B, Tawas City, MI 48763-8314 | 2010-04-21 |
| 1922188804 | Cathleen M Garner | Audiologist | 110 Beech St, Suite C, Tawas City, MI 48763-8314 | 2006-10-16 |
| 1326054735 | John P Blocksom | Orthopaedic Surgery | 110 Beech St, Tawas City, MI 48763-8314 | 2006-07-31 |
| 1558375956 | Susan D Wilson | Hearing Instrument Specialist | 110 Beech St, Tawas City, MI 48763-8314 | 2006-07-28 |
| 1801887377 | Molly A Minard | Orthopaedic Surgery | 110 Beech St, Ste B, Tawas City, MI 48763-8314 | 2005-11-02 |
| 1508854860 | Diana Ennes | Orthopaedic Surgery | 110 Beech St, Tawas City, MI 48763-8314 | 2005-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720447006 | Josie Short | Student in an Organized Health Care Education/Training Program | 127 Wheeler Street, Tawas, MI 48763 | 2016-02-16 |
| 1689052698 | Victoria Mcgillis | Nurse Practitioner | 325 E M 55 Ste B, Tawas City, MI 48763 | 2015-05-11 |
| 1942500160 | Jeffrey M Chadwick O D P C | Optometrist | 325 M-55, Tawas City, MI 48763 | 2010-10-22 |
| 1659536068 | Josip Petani | Pediatrics | 101 W. Lake St, Tawas City, MI 48763 | 2008-07-24 |
| 1790963312 | Phillip A Wienczewski Pllc | Dentist | 671 E M 55, Tawas City, MI 48763 | 2008-02-06 |
| 1902090038 | Life Family Chiropractic LLC | Chiropractor | 196 M 55, Life Family Chiropractic, Tawas City, MI 48763 | 2007-08-31 |
| 1467586446 | Thomas Aldrich Dawson | Dentist | 508 Hemlock Avenue, Tawas City, MI 48763 | 2007-03-14 |
| 1497819056 | Phillip Allen Wienczewski | Dentist | 671 E M55, Tawas City, MI 48763 | 2006-12-20 |
| 1821163106 | Charles Edward Kudwa | Dentist | 510 West Lake St, Tawas City, MI 48763 | 2006-11-21 |
| 1720017312 | Jeffrey Michael Chadwick | Optometrist | 325 M-55 East, Tawas City, MI 48763 | 2006-07-03 |
| Find all providers in zip 48763 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356503338 | St Joseph Health System Inc | Physician Assistant | 110 Beech St Ste B, Tawas City, MI 48763-8314 | 2008-06-30 |
| 1326056532 | Richard Meshew | Physician Assistant | 700 German St, Tawas City, MI 48763-9349 | 2006-08-03 |
| 1780692251 | Sharon Langley | Physician Assistant | 200 Hemlock, Tawas City, MI 48763 | 2006-08-03 |
| 1669499133 | Dwight Fiske | Physician Assistant | 200 Hemlock St, Tawas City, MI 48763-9237 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022331 | Anna Lynn Shrift | Physician Assistant | 849 Black Hill Ln, Traverse City, MI 49696-8674 | 2020-10-27 |
| 1972102556 | Aaron Buckley | Physician Assistant | 567 Saint Louis St, Ferndale, MI 48220-2436 | 2020-10-23 |
| 1013516194 | Rebecca Mary Cronin | Physician Assistant | 4311 Kingsbrook Dr, Kalamazoo, MI 49006-3909 | 2020-10-20 |
| 1801495023 | Keriah Khairi Abd | Physician Assistant | 42836 Bloomingdale Dr, Sterling Heights, MI 48314-2843 | 2020-10-19 |
| 1154929016 | Angela Varghese | Physician Assistant | 461 Tanner Dr, Troy, MI 48085-4714 | 2020-10-13 |
| 1861090730 | Maloree Blayke Perkins | Physician Assistant | 20717 Coventry St, Clinton Twp, MI 48035-1603 | 2020-10-13 |
| 1801494000 | Sarah Puchala Lucero | Physician Assistant | 25614 Wilson Dr, Dearborn Heights, MI 48127-3427 | 2020-10-12 |
| 1871191007 | Julia Marie Tucker | Physician Assistant | 12250 E Ridge Dr, Bruce Twp, MI 48065-2011 | 2020-10-10 |
| 1164020301 | Sara Whitneyann Vandeman | Physician Assistant | 7901 S 12th St Ste 101, Portage, MI 49024-3831 | 2020-10-10 |
| 1831796267 | Jowharh Zindani | Physician Assistant | 12020 Mitchell St, Hamtramck, MI 48212-2722 | 2020-10-08 |
| Find all providers with the same taxonomy | ||||
| City | TAWAS CITY |
| Zip Code | 48763 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.