KERRY P MYCHALISKA (MD) – Pediatrics Physician, NPI 1265539522
Pediatrics Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,204 PEDIATRIC MEDICINE in MI
Provider Addresses for KERRY P MYCHALISKA (MD)
24 FRANK LLOYD WRIGHT DR STE J2000
ANN ARBOR, MI 481059484
Phone: (734) 747-6766
Fax: (734) 222-3100
Type: Mailing
1500 East Medical Center Dr
12th floor CS Mott Childrens Hospital Rm 525
Ann Arbor, MI 481094280
Phone: (734) 763-5302
Type: Location
5301 McAuley Dr
Ypsilanti, MI 48197
Phone: (734) 712-3325
Fax: (734) 712-5525
Type: Location
3535 W 13 Mile Rd Ste Ll
Royal Oak, MI 480736770
Phone: (248) 551-3000
Fax: (248) 551-4784
Type: Location
3601 W 13 Mile Rd
Royal Oak, MI 480736712
Phone: (248) 898-5000
Type: Location
29373 NETWORK PL
CHICAGO, IL 606731293
Phone: (847) 390-5900
Type: Mailing
1675 DEMPSTER ST FL 1
PARK RIDGE, IL 600681110
Phone: (847) 318-9300
Fax: (847) 723-9583
Type: Location
McAuley Drive, Ypsilanti, Washtenaw County, Michigan, 48107, United States
YPSILANTI, MI 48197
Phone: (734) 712-3325
Fax: (734) 712-5525
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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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: 2025-06-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250630003267 | I | Pediatric Medicine | IL | TBD |
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.
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 48105)
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