KENNETH J BOTTESI (MD) – Neurology Physician, NPI 1164419008

KENNETH J BOTTESI (MD) is a healthcare provider. based in Shelby township, Michigan. specializing in NEUROLOGY. They hold the professional credentials MD. They hold a License No. 4301059564 (MI). The NPI Number for KENNETH J BOTTESI (MD) is 1164419008

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
KENNETH J BOTTESI (MD)
NPI
1164419008
Phone
(586) 566-3000
Address
45634 SCHOENHERR RD
Enumeration Date
5 October 2005
Last Update Date
9 March 2009

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5865663000
Graduation Year
1992 (34 years ago)
PAC ID
0840226254
Group Practice PAC ID
0648180406
Professional Enrollment ID
I20050715000937
Address ID
MI483156024SH45634RDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

964 NEUROLOGY in MI

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Provider Addresses for KENNETH J BOTTESI (MD)

  • 45634, Schoenherr Road, Shelby Charter Township, Macomb County, Michigan, 48315, United States

    SHELBY TOWNSHIP, MI 483156024

    Phone: (586) 566-3000

    Fax: (586) 566-3070

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 128 Open Payments records for all available years, with a total value of $2,020.

Total Amount is formed as General ($2,020) + Research ($0) + Ownership ($0) = $2,020.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($704).

Total Amount

$2,020

General + Research + Ownership

Payments

128

Total payment records

General Amount

$2,020

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-07-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050715000937INeurologyMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes488275$0
95886Needle measurement of electrical activity in arm or leg muscles, complete study212106$0
95816Measurement of brain wave activity (eeg), awake and drowsy180178$0
99204New patient office or other outpatient visit, 45-59 minutes9191$0
95912Nerve conduction, 11-12 studies8079$0
View full utilization report →

Insurance plans in this area (ZIP 48315)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648180406View full group profile
NameSpecialtyState
Dentist, General Practice, Maxillofacial Surgery, General PracticeMI
-MI
Family PracticeMI
Physician AssistantMI
-MI
Family PracticeMI
Colorectal Surgery (Proctology)MI
-MI
O B S T E T R I C S/ G Y N E C O L O G YMI
Physical Medicine And RehabilitationMI

Reviews

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Frequently asked questions

What identifier follows KENNETH J BOTTESI (MD) across health systems?
The NPI 1164419008 uniquely identifies KENNETH J BOTTESI (MD) in U.S. healthcare data.
Is KENNETH J BOTTESI (MD)'s NPI status active today?
Active status means KENNETH J BOTTESI (MD)'s NPI record is not deactivated in the public file.
What type of care does KENNETH J BOTTESI (MD) provide?
KENNETH J BOTTESI (MD)'s profile centers on Neurology Physician. Clinical services aligned with this taxonomy classification.
Is KENNETH J BOTTESI (MD) tied to Shelby Township, Michigan?
If you are local to Shelby Township, Michigan, KENNETH J BOTTESI (MD) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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