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KELLY MARIE POLETIS PA-C
NPI 1528317153
Physician Assistant in Clinton Twp, MI

Active since August 29, 2012PECOS EnrolledAccepts Medicare Assignment
15855 19 MILE RD, CLINTON TWP, MI 48038(586) 263-2113 Get Directions Write a Review

NPPES record last updated: September 4, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kelly Marie Poletis Pa-c NPPES

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

KELLY MARIE POLETIS PA-C (NPI 1528317153) is an individual physician assistant in Clinton Twp, Michigan, licensed in Michigan (5601007695) and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS, is affiliated with Henry Ford Macomb Hospital, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1528317153
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKELLY MARIE POLETISCredential: PA-C
Location Address15855 19 MILE RDClinton Twp, MI 48038
Mailing Address1 Ford Pl Ste 2eDetroit, MI 48202-3450 · (313) 874-4806 · Fax (313) 876-1305
Phone(586) 263-2113
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateAugust 29, 2012
Last NPPES UpdateSeptember 4, 2018
✔ NPI 1528317153 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601007695
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License 085004402 (IL)
15855 19 MILE RD, Clinton Twp, MI 48038
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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

Kelly Marie Poletis Pa-c 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 ID5799060240
PECOS Enrollment IDI20171212001846
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

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 high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
24 services24 patients

Hospital Affiliations CMS Care Compare

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

Henry Ford Macomb Hospital

Acute Care Hospitals · Clinton Township, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230047
Location15855 Nineteen Mile RdClinton Township, MI 48038 · Macomb County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48038 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
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
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.

MS. LEEANN WICKENS P.A.
Physician Assistant
15855 19 MILE RD
CLINTON TWP, MI 48038
Macomb County (586) 203-1940
CYNTHIA GEE D.O.
Emergency Medicine
15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
Macomb County (701) 340-2053
SARAH E NELSON
Nurse Practitioner (Adult Health)
15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
Macomb County (313) 623-7602
MS. KARA NICOLE SZCZOMAK PA-C
Physician Assistant
15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
Macomb County (586) 263-2601
EMILY SOPEL
Occupational Therapist
15855 19 MILE RD
CLINTON TWP, MI 48038
Macomb County (586) 263-2300
ANTONIO MACERI MD
Student in an Organized Health Care Education/Training Program
15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038
Macomb County (586) 263-2300
HENRY FORD MACOMB HOSPITAL CORPORATION
General Acute Care Hospital
15855 19 MILE RD
CLINTON TWP, MI 48038
Macomb County (568) 263-2705
JEFFREY A BERG CRNA
Nurse Anesthetist, Certified Registered
15855 19 MILE RD
CLINTON TWP, MI 48038
Macomb County (586) 263-2370

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 Poletis's NPI number?

The NPI number for Kelly Poletis is 1528317153. It was assigned to this individual provider in the NPPES registry on August 29, 2012.

Where is Kelly Poletis located?

Kelly Poletis practices at 15855 19 Mile Rd, Clinton Twp, MI 48038. The listed phone number is (586) 263-2113.

What is Kelly Poletis's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kelly Poletis enrolled in Medicare?

Yes. Kelly Poletis 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 Kelly Poletis 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 Kelly Poletis 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 Kelly Poletis affiliated with any hospitals?

According to CMS data, Kelly Poletis is affiliated with Henry Ford Macomb Hospital.

When was this NPI record last updated?

The NPPES record for Kelly Poletis was last updated on September 4, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.