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KATHRYN MARIE POULOS
NPI 1083988323
Physician Assistant in Plymouth, MI

Active since March 05, 2012PECOS EnrolledAccepts Medicare Assignment
9377 N HAGGERTY RD, PLYMOUTH, MI 48170(734) 451-0070(734) 451-1583 Get Directions Write a Review

NPPES record last updated: October 22, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 22, 2019, Sep 20, 2016 (2 updates tracked since 2016).

About Kathryn Marie Poulos NPPES

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

KATHRYN MARIE POULOS (NPI 1083988323) is an individual physician assistant in Plymouth, Michigan, licensed in Michigan (5601006317) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS, maintains a secondary practice location in Eastpointe, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1083988323
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKATHRYN MARIE POULOS
Location Address9377 N HAGGERTY RDPlymouth, MI 48170
Mailing Address9377 N Haggerty RdPlymouth, MI 48170-4622 · (734) 451-0070 · Fax (734) 451-1583
Phone(734) 451-0070
Fax(734) 451-1583
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateMarch 5, 2012
Last NPPES UpdateOctober 22, 20192 updates tracked since enumeration
✔ NPI 1083988323 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601006317
Definition
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.
9377 N HAGGERTY RD, Plymouth, MI 48170
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Secondary Practice Location 1

Location 122301 Kelly RdEastpointe, MI 48021-2619 · Phone (586) 443-5588 · Fax (586) 443-5538

Other Identifiers 1

Other5601006317MI · License

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, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kathryn Marie Poulos 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 ID4880855998
PECOS Enrollment IDI20120417000771
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.

Areas of Expertise CMS Part B claims 9

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.

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.
193 services74 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
75 services24 patients
Injection, ketorolac tromethamine, per 15 mg J1885
Ketorolac tromethamine is a medication administered through injection, often used to manage moderate to severe pain. Each 15 mg dose helps to reduce hormones causing inflammation and pain in the body. It is not recommended for long-term use.
54 services11 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.
49 services33 patients
Telephone medical discussion with physician, 5-10 minutes 99441
A telephone medical discussion with a physician is a brief, 5-10 minute call where you can discuss your health concerns. It's a convenient way to receive medical advice without needing to visit a clinic. It's important to prepare questions in advance to make the most of this time.
48 services29 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
43 services43 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48170 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.

Other Providers at the Same Location NPPES

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

DR. JESSE MARTINEZ D.O.
Internal Medicine
9377 N HAGGERTY RD
PLYMOUTH, MI 48170
Wayne County (734) 451-0070

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 Kathryn Poulos's NPI number?

The NPI number for Kathryn Poulos is 1083988323. It was assigned to this individual provider in the NPPES registry on March 5, 2012.

Where is Kathryn Poulos located?

Kathryn Poulos practices at 9377 N Haggerty Rd, Plymouth, MI 48170. The listed phone number is (734) 451-0070.

What is Kathryn Poulos's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kathryn Poulos enrolled in Medicare?

Yes. Kathryn Poulos 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.

What insurance does Kathryn Poulos accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community, Priority Health and UnitedHealthcare list Kathryn Poulos 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.

When was this NPI record last updated?

The NPPES record for Kathryn Poulos was last updated on October 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.