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ANDREW JOHN KETNER D.O.
NPI 1043574874
Orthopaedic Surgery in Waterford, MI

Active since June 26, 2012PECOS EnrolledAccepts Medicare Assignment
80.59/100
CMS Quality Rating
4000 HIGHLAND RD STE 101, WATERFORD, MI 48328(248) 270-5622(248) 856-2474 Get Directions Write a Review

NPPES record last updated: November 18, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 18, 2025, May 16, 2019, Jun 15, 2018 (3 updates tracked since 2018).

About Andrew John Ketner D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREW JOHN KETNER D.O. (NPI 1043574874) is an individual orthopaedic surgery provider in Waterford, Michigan, licensed in Michigan (5101019855) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Trinity Health Oakland Hospital, and is a graduate of Michigan State University College Of Osteopathic Medicine (2012).

NPPES Registry Identity

NPI1043574874
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameANDREW JOHN KETNERCredential: D.O.
Location Address4000 HIGHLAND RD STE 101Waterford, MI 48328-2163
Mailing Address4000 Highland Rd Ste 101Waterford, MI 48328-2163 · (248) 270-5622 · Fax (248) 856-2474
Phone(248) 270-5622
Fax(248) 856-2474
Sole ProprietorNo
Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 2012
Enumeration DateJune 26, 2012
Last NPPES UpdateNovember 18, 20253 updates tracked since enumeration
NPPES CertifiedNovember 18, 2025
✔ NPI 1043574874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in MI · 5101019855
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
4000 HIGHLAND RD STE 101, Waterford, MI 48328
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andrew John Ketner D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224271648
PECOS Enrollment IDI20180710001532
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Andrew Ketner reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ketner Orthopedics PLLC
Same address
Adult Reconstructive Orthopaedic Surgery
4000 HIGHLAND RD STE 101
Waterford, MI 48328
  • Reassigned Medicare billing, Michigan enrollment
NPI 1790670958 (248) 270-5622
Vhs Physicians Of Michigan
11 mi
Internal Medicine
29201 TELEGRAPH RD STE 404N
Southfield, MI 48034
  • Reassigned Medicare billing, Michigan enrollment
  • 407 clinicians in this Medicare group
NPI 1073827101 (248) 450-3507

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
286 services39 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
107 services76 patients
X-ray of hip, 2-3 views 73502
An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
99 services61 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
81 services65 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
69 services43 patients
X-ray of knee, 4 or more views 73564
An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
52 services46 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Trinity Health Oakland Hospital

Acute Care Hospitals · Pontiac, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230029
Location44405 Woodward AvePontiac, MI 48341 · Oakland County
Emergency services Birthing friendly

Huron Valley-Sinai Hospital

Acute Care Hospitals · Commerce Township, MI
3/5 CMS rating
OwnershipProprietary
CMS Certification Number230277
LocationOne William Carls DriveCommerce Township, MI 48382 · Oakland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48328 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.59/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality53.55
Promoting Interoperability100
Improvement Activities40
Cost52.03

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEVEN MATTHEW HUBERT PAC
Physician Assistant (Surgical)
4000 HIGHLAND RD STE 101
WATERFORD, MI 48328
Oakland County (248) 270-5622
KETNER ORTHOPEDICS PLLC
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
4000 HIGHLAND RD STE 101
WATERFORD, MI 48328
Oakland County (248) 270-5622

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrew Ketner's NPI number?

The NPI number for Andrew Ketner is 1043574874. It was assigned to this individual provider in the NPPES registry on June 26, 2012.

Where is Andrew Ketner located?

Andrew Ketner practices at 4000 Highland Rd Ste 101, Waterford, MI 48328. The listed phone number is (248) 270-5622.

What is Andrew Ketner's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Andrew Ketner enrolled in Medicare?

Yes. Andrew Ketner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Andrew Ketner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Ketner reassigns Medicare benefits to 2 organizations: Ketner Orthopedics PLLC (Waterford, MI) and Vhs Physicians Of Michigan (Southfield, MI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrew Ketner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Andrew Ketner accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Andrew Ketner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Andrew Ketner affiliated with any hospitals?

According to CMS data, Andrew Ketner is affiliated with Trinity Health Oakland Hospital and Huron Valley-Sinai Hospital.

When was this NPI record last updated?

The NPPES record for Andrew Ketner was last updated on November 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.