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DR. FALLON KAPATAIS M.D
NPI 1477811925
Family Medicine in Novi, MI

Active since May 02, 2012PECOS EnrolledAccepts Medicare Assignment
40015 GRAND RIVER AVE STE 100, NOVI, MI 48375(248) 473-8580(248) 474-4208 Get Directions Write a Review

NPPES record last updated: April 23, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 23, 2021, Feb 16, 2016 (2 updates tracked since 2016).

About Dr. Fallon Kapatais M.d NPPES

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

DR. FALLON KAPATAIS M.D (NPI 1477811925) is an individual family medicine provider in Novi, Michigan, licensed in Michigan (4301100316) and active in the NPI registry since May 2012. She is enrolled in Medicare PECOS, is affiliated with Ascension Providence Hospital, Southfield And Novi, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1477811925
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. FALLON KAPATAISCredential: M.D
Location Address40015 GRAND RIVER AVE STE 100Novi, MI 48375-2160
Mailing Address40015 Grand River Ave Ste 100Novi, MI 48375-2160 · (248) 473-8580 · Fax (248) 474-4208
Phone(248) 473-8580
Fax(248) 474-4208
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateMay 2, 2012
Last NPPES UpdateApril 23, 20212 updates tracked since enumeration
NPPES CertifiedApril 23, 2021
✔ NPI 1477811925 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 4301100316
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
40015 GRAND RIVER AVE STE 100, Novi, MI 48375
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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

Dr. Fallon Kapatais M.d 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 ID941529101
PECOS Enrollment IDI20150826001447
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 10

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.
346 services194 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.
245 services193 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
117 services97 patients
X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
88 services80 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
58 services55 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.
23 services23 patients

Hospital Affiliations CMS Care Compare 4

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

Ascension Providence Hospital, Southfield And Novi

Acute Care Hospitals · Southfield, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number230019
Location16001 W Nine Mile RdSouthfield, MI 48075 · Oakland County
Emergency services Birthing friendly

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230130
Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County
Emergency services Birthing friendly

Beaumont Hospital - Farmington Hills

Acute Care Hospitals · Farmington Hills, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230151
Location28050 Grand River AvenueFarmington Hills, MI 48336 · Oakland County
Emergency services Birthing friendly

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 48375 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.

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 Fallon Kapatais's NPI number?

The NPI number for Fallon Kapatais is 1477811925. It was assigned to this individual provider in the NPPES registry on May 2, 2012.

Where is Fallon Kapatais located?

Fallon Kapatais practices at 40015 Grand River Ave Ste 100, Novi, MI 48375. The listed phone number is (248) 473-8580.

What is Fallon Kapatais's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Fallon Kapatais enrolled in Medicare?

Yes. Fallon Kapatais 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 Fallon Kapatais accept?

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

Is Fallon Kapatais affiliated with any hospitals?

According to CMS data, Fallon Kapatais is affiliated with Ascension Providence Hospital, Southfield And Novi, Beaumont Hospital Royal Oak, Beaumont Hospital - Farmington Hills and Henry Ford Health West Bloomfield Hospital.

When was this NPI record last updated?

The NPPES record for Fallon Kapatais was last updated on April 23, 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.