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SOUTHEASTERN MICHIGAN KIDNEY CENTER PLLC
NPI 1316967797
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Berkley, MI

Active since July 20, 2006CLIA 23D0951130 · Waiver
2/5
Overall Rating
1695 W 12 MILE RD, SUITE 250, BERKLEY, MI 48072(248) 414-5200(248) 414-5227 Get Directions Write a Review

NPPES record last updated: September 28, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Southeastern Michigan Kidney Center Pllc NPPES

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

SOUTHEASTERN MICHIGAN KIDNEY CENTER PLLC (NPI 1316967797) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Berkley, Michigan and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through September 13, 2026 and lists David F Shepherd, Vice President, as its authorized official.

NPPES Registry Identity

NPI1316967797
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameSOUTHEASTERN MICHIGAN KIDNEY CENTER PLLC
Location Address1695 W 12 MILE RD, SUITE 250Berkley, MI 48072-2183
Mailing Address30100 Telegraph Rd, Suite 200Bingham Farms, MI 48025-4516 · (248) 723-0224 · Fax (248) 642-7852
Phone(248) 414-5200
Fax(248) 414-5227
Organization SubpartNo
Authorized OfficialDavid F ShepherdVice President · (248) 642-5038
Enumeration DateJuly 20, 2006
Last NPPES UpdateSeptember 28, 2011
✔ NPI 1316967797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
1695 W 12 MILE RD, Berkley, MI 48072
Open in Google Maps ↗

Other Identifiers 16

Other232574Hap
Other08981Blue Cross Primary
Medicaid4112097MI
Other1022510001Wellness
OtherP117519Blue Care Network
Other000000009371Cape
Medicare ID-Type Unspecified232574MI
Other140042Preferred Choice
Other8203Greatlakes
Other08981Fed Blue Cross Primary
Other567595Selectcare
OtherOP630345M Care
Other09499Blue Cross Secondary
Other501076Ulti Med
Other09499Fed Blue Cross Secondary
Other140042Care Choices

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0951130

Southeastern Michigan Kidney Center · Berkley, MI
Active · expires Sep 13, 2026
CLIA Number23D0951130
Laboratory TypeEnd Stage Renal Disease Dialysis Facility
Certificate Effective DateSeptember 14, 2024
Certificate Expiration DateSeptember 13, 2026
Laboratory DirectorOlaf C. Kroneman
Laboratory Phone(248) 414-5200
Laboratory LocationSoutheastern Michigan Kidney Center1695 West Twelve Mile, Suite 250, Berkley, MI 48072
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Dialysis Facility Quality Ratings CMS Care Compare

Quality ratings, services and patient survey results for Southeast Michigan Kidney Center (CMS certification number 232574), from CMS Care Compare.

Southeast Michigan Kidney Center

Dialysis facility · Berkley, MI
2/5 CMS RatingRating period January 2020 to December 2023
OwnershipProfit
ChainGreenfield Health Systems
CMS Certification Number232574
ESRD NetworkNetwork 11
Hemodialysis Stations2
Medicare-Certified SinceJune 2, 1999
Location1695 W 12 MILE RD, SUITE 250Berkley, MI 48072 · Oakland County
Phone(248) 414-5200
Services Offered
Peritoneal dialysis

Other Providers at the Same Location NPPES 14

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

QUEST DIAGNOSTICS INCORPORATED MI
Clinical Medical Laboratory
1695 W 12 MILE RD, STE 200
BERKLEY, MI 48072
Oakland County (248) 398-1601
DR. RUTH ANAN PH.D.
Psychologist (Clinical)
1695 W 12 MILE RD, SUITE 120
BERKLEY, MI 48072
Oakland County (248) 691-4744
DR. DONALD S ROSIN MD
Internal Medicine
1695 W 12 MILE RD, SUITE 200
BERKLEY, MI 48072
Oakland County (248) 548-9090
DR. OLAF C KRONEMAN III MD
Internal Medicine (Nephrology)
1695 W 12 MILE RD, SUITE 250
BERKLEY, MI 48072
Oakland County (248) 414-3874
ERNEST KRUG
Pediatrics (Developmental - Behavioral Pediatrics)
1695 W 12 MILE RD, STE. 120
BERKLEY, MI 48072
Oakland County (248) 691-4744
DR. JACOB BENJAMIN MECHLOWITZ DPM
Podiatrist
1695 W 12 MILE RD
BERKLEY, MI 48072
Oakland County (248) 808-6012
ASSOCIATED PHYSICIANS GROUP PLC
Internal Medicine
1695 W 12 MILE RD, SUITE 200
BERKLEY, MI 48072
Oakland County (248) 548-9090
MS. JAMIE E MCGILLIVARY MS, LLP, BCBA
Psychologist (Clinical Child & Adolescent)
1695 W 12 MILE RD, 120
BERKLEY, MI 48072
Oakland County (248) 691-4774

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 Southeastern Michigan Kidney Center PLLC's NPI number?

The NPI number for Southeastern Michigan Kidney Center PLLC is 1316967797. It was assigned to this organization in the NPPES registry on July 20, 2006.

Where is Southeastern Michigan Kidney Center PLLC located?

Southeastern Michigan Kidney Center PLLC is located at 1695 W 12 Mile Rd Suite 250, Berkley, MI 48072. The listed phone number is (248) 414-5200.

What is Southeastern Michigan Kidney Center PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

Does Southeastern Michigan Kidney Center PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0951130) is associated with this NPI, valid through September 13, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Southeastern Michigan Kidney Center PLLC a Medicare-certified dialysis facility?

Yes. Southeast Michigan Kidney Center is a Medicare-certified dialysis facility, certified since June 2, 1999.

What quality rating does Southeastern Michigan Kidney Center PLLC have?

CMS rates Southeast Michigan Kidney Center 2 out of 5 stars on Care Compare. The full measure detail is in the Dialysis Facility Quality section above.

What insurance does Southeastern Michigan Kidney Center PLLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Southeastern Michigan Kidney Center PLLC 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 Southeastern Michigan Kidney Center PLLC was last updated on September 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.