1. Home
  2. Directory
  3. Michigan
  4. St Clair Shores
  5. Family Medicine
  6. NPI Profile

KATHLEEN M FULGENZI MD
NPI 1588656102
Family Medicine in St Clair Shores, MI

Active since August 19, 2005PECOS Enrolled
24911 LITTLE MACK AVE, ST CLAIR SHORES, MI 48080(586) 777-2050(586) 777-2189 Get Directions Write a Review

NPPES record last updated: February 18, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kathleen M Fulgenzi Md NPPES

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

KATHLEEN M FULGENZI MD (NPI 1588656102) is an individual family medicine provider in St Clair Shores, Michigan, licensed in Michigan (4301042670) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588656102
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKATHLEEN M FULGENZICredential: MD
Location Address24911 LITTLE MACK AVESt Clair Shores, MI 48080-3200
Mailing Address43800 Garfield RdClinton Twp, MI 48038-1136 · (586) 777-2050 · Fax (586) 777-2189
Phone(586) 777-2050
Fax(586) 777-2189
Sole ProprietorNo
Enumeration DateAugust 19, 2005
Last NPPES UpdateFebruary 18, 2014
✔ NPI 1588656102 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 · 4301042670
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.
24911 LITTLE MACK AVE, St Clair Shores, MI 48080
Open in Google Maps ↗

Other Identifiers 4

Medicare UPINB416131
Medicaid4420765MI
Medicare ID-Type UnspecifiedM71670052
Other0Q262160MI · Blue Cross

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathleen M Fulgenzi Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48080 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
36%123 patients2/55-star benchmark: 92%
Cervical Cancer Screening
Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: - Women age 21-64 who had cervical cytology performed every 3 years - Women age 30-64 who had cervical cytology/human papillomavirus (HPV)…
34%234 patients
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
32%217 patients2/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
33%36 patients2/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
96%769 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
92%226 patients3/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
94%983 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
37%593 patients2/55-star benchmark: 97%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%60 patients5/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
66%983 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
27%983 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
23%983 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

PATRICIA WEST PHD, RN
Nurse Practitioner (Psychiatric/Mental Health)
24911 LITTLE MACK AVE, SUITE C
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 447-9070
KENNETH W BOLLIN MD
Family Medicine
24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 777-2050
MITCHELL BECKER
Family Medicine
24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 777-2050
EILEEN MARGARET REICKERT MD
Family Medicine
24911 LITTLE MACK AVE
ST CLAIR SHORES, MI 48080
Macomb County (586) 777-2050
DR. TERRY KENNETH DELUCA M.D.
Family Medicine
24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 777-2050
DR. RITA SALEEM JADDOU M.D.
Family Medicine
24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 447-9064
ST. JOHN FAMILY CENTER
Clinic/Center
24911 LITTLE MACK AVE, SUITE C
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 753-0011
SAMINEH MIRHEYDARI MD
Family Medicine
24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 777-2050

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 Kathleen Fulgenzi's NPI number?

The NPI number for Kathleen Fulgenzi is 1588656102. It was assigned to this individual provider in the NPPES registry on August 19, 2005.

Where is Kathleen Fulgenzi located?

Kathleen Fulgenzi practices at 24911 Little Mack Ave, St Clair Shores, MI 48080. The listed phone number is (586) 777-2050.

What is Kathleen Fulgenzi's specialty?

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

Is Kathleen Fulgenzi enrolled in Medicare?

Yes. Kathleen Fulgenzi is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kathleen Fulgenzi was last updated on February 18, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.