DR. KELLY SUSEWITZ SHAKOOR (FNP-BC) – Family Nurse Practitioner, NPI 1043794829
Preparing for Medicare enrollment?
Use our CMS-855 prep checklist: which form applies (855I, 855O, or 855A), readiness score, NPPES field map, and Section 12 documents. Reassignment uses CMS-855I Section 4F—not the discontinued CMS-855R form.
Open Medicare 855 Prep tool →Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. KELLY SUSEWITZ SHAKOOR (FNP-BC)
400 N Ingalls St
Ann Arbor, MI 481092003
Phone: (734) 763-5985
Type: Location
4169, Kingston Street, Southwestern Outer Drive, Dearborn Heights, Wayne County, Michigan, 48125, United States
DEARBORN HEIGHTS, MI 481253237
Phone: (734) 306-8586
Type: Mailing
Telegraph Road, Redford Township, Wayne County, Michigan, 48223, United States
REDFORD, MI 482391260
Phone: (313) 450-4500
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $18.
Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.
Last reported payment date: 2024-09-11 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($18).
Total Amount
$18
General + Research + Ownership
Payments
1
Total payment records
General Amount
$18
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $18 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48109)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | MI | |
| Mental Health Counselor | MI | |
| - | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| Mental Health Counselor | MI | |
| - | MI | |
| Physician Assistant | MI | |
| Mental Health Counselor | MI | |
| - | MI |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.