Kenneth Grant Masters, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Detroit, Michigan. His current practice location is
4201 Saint Antoine St, Detroit, Michigan. You can reach out to his office (for appointments etc.) via phone at
(313) 745-3000.
Kenneth Grant Masters is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1295355063.
Physician's Profile
Full Name | Kenneth Grant Masters |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 4201 Saint Antoine St, Detroit, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1295355063
- Provider Enumeration Date: 04/22/2020
- Last Update Date: 02/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 0042641839
- Enrollment ID: I20240104001484
Medical Identifiers
Medical identifiers for Kenneth Grant Masters such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1295355063 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207L00000X | Anesthesiology | 5101027678 (Michigan) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kenneth Grant Masters allows following entities to bill medicare on his behalf.
Entity Name | Northstar Anesthesia Of Michigan Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1871986372 PECOS PAC ID: 9638481591 Enrollment ID: O20150707000070 |
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Entity Name | Nsa Pain Services Of Michigan Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1407229479 PECOS PAC ID: 6406150408 Enrollment ID: O20160211002503 |
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Entity Name | Beaumont Medical Group Hospital Based Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1427567858 PECOS PAC ID: 3072875889 Enrollment ID: O20180314001796 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Grant Masters is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kenneth Grant Masters, DO 3990 John R St # 162, Detroit, MI 48201-2018 Ph: (313) 745-7233 | Kenneth Grant Masters, DO 4201 Saint Antoine St, Detroit, MI 48201-2153 Ph: (313) 745-3000 |
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