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MRS. KELCIE ANN WAACK FNP
NPI 1730762246
Internal Medicine in Southgate, MI

Active since May 03, 2021PECOS EnrolledAccepts Medicare Assignment
3 HERITAGE CENTER, SOUTHGATE, MI 48195(734) 283-3222(734) 283-4006 Get Directions Write a Review

NPPES record last updated: December 8, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 8, 2023, May 3, 2021 (2 updates tracked since 2021).

About Mrs. Kelcie Ann Waack Fnp NPPES

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

MRS. KELCIE ANN WAACK FNP (NPI 1730762246) is an individual internal medicine provider in Southgate, Michigan, licensed in Michigan (4704333571) and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital - Dearborn, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1730762246
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameMRS. KELCIE ANN WAACKCredential: FNP
Location Address3 HERITAGE CENTERSouthgate, MI 48195
Mailing Address19169 Hannan RdNew Boston, MI 48164-9371 · (313) 605-3418
Phone(734) 283-3222
Fax(734) 283-4006
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMay 3, 2021
Last NPPES UpdateDecember 8, 20232 updates tracked since enumeration
NPPES CertifiedDecember 8, 2023
✔ NPI 1730762246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 4704333571
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
3 HERITAGE CENTER, Southgate, MI 48195
Open in Google Maps ↗

Other Identifiers 1

MedicaidF04210455MI

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

Mrs. Kelcie Ann Waack Fnp 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 ID6901390418
PECOS Enrollment IDI20251211002996
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.

Hospital Affiliations CMS Care Compare 3

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

Beaumont Hospital - Dearborn

Acute Care Hospitals · Dearborn, MI
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230020
Location18101 Oakwood BlvdDearborn, MI 48124 · Wayne County
Emergency services Birthing friendly

Henry Ford Health Wyandotte Hospital

Acute Care Hospitals · Wyandotte, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230146
Location2333 Biddle AveWyandotte, MI 48192 · Wayne County
Emergency services Birthing friendly

Surgeons Choice Medical Center

Acute Care Hospitals · Southfield, MI
OwnershipProprietary
CMS Certification Number230301
Location22401 Foster Winter DriveSouthfield, MI 48075 · Oakland County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48195 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
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
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.

Other Providers at the Same Location NPPES

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

SOUTHGATE MEDICAL GROUP, PLLC
Internal Medicine
3 HERITAGE CENTER, SUITE 1
SOUTHGATE, MI 48195
Wayne County (734) 283-3222

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 Kelcie Waack's NPI number?

The NPI number for Kelcie Waack is 1730762246. It was assigned to this individual provider in the NPPES registry on May 3, 2021.

Where is Kelcie Waack located?

Kelcie Waack practices at 3 Heritage Center, Southgate, MI 48195. The listed phone number is (734) 283-3222.

What is Kelcie Waack's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kelcie Waack enrolled in Medicare?

Yes. Kelcie Waack 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.

Is Kelcie Waack affiliated with any hospitals?

According to CMS data, Kelcie Waack is affiliated with Beaumont Hospital - Dearborn, Henry Ford Health Wyandotte Hospital and Surgeons Choice Medical Center.

When was this NPI record last updated?

The NPPES record for Kelcie Waack was last updated on December 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.