KENNETH GRANT MASTERS DO
NPI 1295355063
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since April 22, 2020PECOS EnrolledAccepts Medicare Assignment
4201 SAINT ANTOINE ST, DETROIT, MI 48201(313) 745-3000 Get Directions Write a Review

NPPES record last updated: August 5, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 5, 2025, Apr 22, 2020 (2 updates tracked since 2020).

About Kenneth Grant Masters Do NPPES

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

KENNETH GRANT MASTERS DO (NPI 1295355063) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with Sinai-grace Hospital, and maintains a secondary practice location in Taylor.

NPPES Registry Identity

NPI1295355063
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameKENNETH GRANT MASTERSCredential: DO
Location Address4201 SAINT ANTOINE STDetroit, MI 48201-2153
Mailing Address3990 John R St # 162Detroit, MI 48201-2018 · (313) 745-7233
Sole ProprietorNo
Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 2020
Enumeration DateApril 22, 2020
Last NPPES UpdateAugust 5, 20252 updates tracked since enumeration
NPPES CertifiedAugust 5, 2025
NPI 1295355063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedAnesthesiologyTaxonomy 207L00000X · License 5101027678 (MI)
4201 SAINT ANTOINE ST, Detroit, MI 48201

Secondary Practice Location 1

Location 110000 Telegraph RdTaylor, MI 48180-3330 · Phone (313) 295-5000

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

Kenneth Grant Masters Do 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 ID42641839
PECOS Enrollment IDI20240104001484
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.

Hospital Affiliations CMS Care Compare 4

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

Sinai-Grace Hospital

Acute Care Hospitals · Detroit, MI
1/5 CMS rating
OwnershipProprietary
CMS Certification Number230024
Location6071 W Outer DriveDetroit, MI 48235 · Wayne County
Emergency services Birthing friendly

Harper University Hospital

Acute Care Hospitals · Detroit, MI
1/5 CMS rating
OwnershipProprietary
CMS Certification Number230104
Location3990 John R StreetDetroit, MI 48201 · Wayne County
Emergency services Birthing friendly

Detroit Receiving Hospital

Acute Care Hospitals · Detroit, MI
1/5 CMS rating
OwnershipProprietary
CMS Certification Number230273
Location4201 St Antoine St - 2cDetroit, MI 48201 · Wayne County
Emergency services

Karmanos Cancer Center

Acute Care Hospitals · Detroit, MI
3/5 CMS rating
OwnershipProprietary
CMS Certification Number230297
Location4100 John RDetroit, MI 48201 · Wayne County

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.

Nurse Anesthetist, Certified Registered
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Radiology (Diagnostic Radiology)
4201 SAINT ANTOINE ST, DRH 3L-8
DETROIT, MI 48201
Orthopaedic Surgery
4201 SAINT ANTOINE ST, STE. 6B
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
4201 SAINT ANTOINE ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
4201 SAINT ANTOINE ST
DETROIT, MI 48201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295355063, enumerated as an "individual" on April 22, 2020.

The provider is located at 4201 SAINT ANTOINE ST DETROIT, MI 48201 and the phone number is (313) 745-3000.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Kenneth Masters is affiliated with: SINAI-GRACE HOSPITAL, HARPER UNIVERSITY HOSPITAL, DETROIT RECEIVING HOSPITAL and KARMANOS CANCER CENTER.