MRS. CASSANDRA KONDYLIS ACNPC-AG
NPI 1114605250
Nurse Practitioner - Adult Health in West Bloomfield, MI

Q: What is Cassandra Kondylis's NPI number?

The NPI number for Cassandra Kondylis is 1114605250. It was assigned to this individual provider in the NPPES registry on July 10, 2023.

Q: What is Cassandra Kondylis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Active since July 10, 2023PECOS EnrolledAccepts Medicare Assignment

6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322(800) 653-6568 Get Directions Write a Review

NPPES record last updated: December 9, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 9, 2025, Jul 10, 2023 (2 updates tracked since 2023).

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About Mrs. Cassandra Kondylis Acnpc-ag NPPES

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

MRS. CASSANDRA KONDYLIS ACNPC-AG (NPI 1114605250) is an individual adult health provider in West Bloomfield, Michigan, licensed in Michigan (4704425980) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS, is affiliated with Henry Ford Health West Bloomfield Hospital, and maintains a secondary practice location in Cleveland.

NPPES Registry Identity

NPI1114605250

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMRS. CASSANDRA KONDYLISCredential: ACNPC-AG

Location Address6777 W MAPLE RDWest Bloomfield, MI 48322-3013

Mailing Address1 Ford Pl Ste 3aDetroit, MI 48202-3450 · (313) 874-4806

Phone(800) 653-6568

Sole ProprietorNo

Medical School CMSKent State University College Of Podiatric MedicineGraduated 2023

Enumeration DateJuly 10, 2023

Last NPPES UpdateDecember 9, 20252 updates tracked since enumeration

NPPES CertifiedDecember 9, 2025

✔ NPI 1114605250 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in MI · 4704425980

Also ListedNurse Practitioner · Acute CareTaxonomy 363LA2100X · License APRN.CNP.0034294 (OH)

6777 W MAPLE RD, West Bloomfield, MI 48322

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Secondary Practice Location 1

Location 19500 Euclid AveCleveland, OH 44195-0002 · Phone (216) 444-2200

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

Mrs. Cassandra Kondylis Acnpc-ag 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 ID6103288451

PECOS Enrollment IDI20251215003320

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 Reassignment

Medicare enrollment records show Cassandra Kondylis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Henry Ford Health System

20 mi

Nurse Practitioner

2799 W GRAND BLVD
Detroit, MI 48202

Reassigned Medicare billing, Michigan enrollment
577 clinicians in this Medicare group

NPI 1104900455 (313) 916-2600

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

Hospital Affiliations CMS Care Compare

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

Henry Ford Health West Bloomfield Hospital

Acute Care Hospitals · West Bloomfield, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230302

Location6777 West Maple RoadWest Bloomfield, MI 48322 · Oakland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48322 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

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

Most-billed visit code 99214

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 20

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

IRB MEDICAL EQUIPMENT LLC

Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)

6777 W MAPLE RD, RM 60-01
WEST BLOOMFIELD, MI 48322

Oakland County (248) 862-7214

MELISSA ANNE BARACH AGCNS

Clinical Nurse Specialist