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KELLY ELIZABETH KRCMARIK M.D.
NPI 1467870394
Psychiatry & Neurology - Child & Adolescent Psychiatry in Grand Rapids, MI

Active since March 28, 2014Opted out of Medicare · through Nov 11, 2027
2511 SAGEWOOD AVE NE UNIT 813, GRAND RAPIDS, MI 49525(616) 204-2067 Get Directions Write a Review

NPPES record last updated: February 7, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 7, 2021, Aug 23, 2016 (2 updates tracked since 2016).

About Kelly Elizabeth Krcmarik M.d. NPPES

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

KELLY ELIZABETH KRCMARIK M.D. (NPI 1467870394) is an individual child & adolescent psychiatry provider in Grand Rapids, Michigan, licensed in Michigan (4301502433) and active in the NPI registry since March 2014. She has opted out of Medicare through November 11, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1467870394
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameKELLY ELIZABETH KRCMARIKCredential: M.D.
Location Address2511 SAGEWOOD AVE NE UNIT 813Grand Rapids, MI 49525-2950
Mailing Address2511 Sagewood Ave Ne Unit 813Grand Rapids, MI 49525-2950 · (616) 204-2067
Phone(616) 204-2067
Sole ProprietorNo
Enumeration DateMarch 28, 2014
Last NPPES UpdateFebruary 7, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 7, 2021
✔ NPI 1467870394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
Licenses✔ Licensed in MI · 4301502433✔ Licensed in MA · 271358
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 4301502433 (MI), 271358 (MA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2511 SAGEWOOD AVE NE UNIT 813, Grand Rapids, MI 49525
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Kelly Elizabeth Krcmarik M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 11, 2021 through November 11, 2027.

Opt-Out Effective DateNovember 11, 2021
Opt-Out In Effect ThroughNovember 11, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Kelly Krcmarik's NPI number?

The NPI number for Kelly Krcmarik is 1467870394. It was assigned to this individual provider in the NPPES registry on March 28, 2014.

Where is Kelly Krcmarik located?

Kelly Krcmarik practices at 2511 Sagewood Ave NE Unit 813, Grand Rapids, MI 49525. The listed phone number is (616) 204-2067.

What is Kelly Krcmarik's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Kelly Krcmarik enrolled in Medicare?

No. Kelly Krcmarik has opted out of Medicare through November 11, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kelly Krcmarik was last updated on February 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.