KENNETH MARK WARDOWSKI (PA) – Physician Assistant, NPI 1831190305

KENNETH MARK WARDOWSKI (PA) is a healthcare provider. based in Southfield, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 5601002147 (MI). The NPI Number for KENNETH MARK WARDOWSKI (PA) is 1831190305

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
KENNETH MARK WARDOWSKI (PA)
NPI
1831190305
Phone
(248) 849-3000
Address
16001 W 9 MILE RD
Enumeration Date
9 August 2005
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2488496033
Graduation Year
1992 (34 years ago)
PAC ID
5698867893
Group Practice PAC ID
6103738703
Professional Enrollment ID
I20070817000194
Address ID
MI480754818SO16001FLOO701
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:20State licenses:2Digital endpointsOther names

6,066 PHYSICIAN ASSISTANT in MI

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Provider Addresses for KENNETH MARK WARDOWSKI (PA)

  • Ascension Providence Hospital, Southfield Campus, 16001, West 9 Mile Road, Southfield, Oakland County, Michigan, 48075, United States

    DEPT OF SURGERY

    SOUTHFIELD, MI 480754818

    Phone: (248) 849-3000

    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 7 Open Payments records for all available years, with a total value of $212.

Total Amount is formed as General ($212) + Research ($0) + Ownership ($0) = $212.

Last reported payment date: 2024-10-22 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($100).

Total Amount

$212

General + Research + Ownership

Payments

7

Total payment records

General Amount

$212

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-22

Latest reported date

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: 2007-08-17

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
I20070817000194IPhysician AssistantMITBD

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
33268Exclusion of appendage of left upper chamber of heart performed during other procedure on chest1616$0
33508Harvest of vein using an endoscope1515$0
33533Coronary artery bypass using artery graft, 1 graft1313$0
View full utilization report →

Insurance plans in this area (ZIP 48075)

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Provider's Procedures

KENNETH MARK WARDOWSKI (PA) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTMI33533Heart artery bypass to repair one artery1515

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: 6103738703View full group profile
NameSpecialtyState
-MI
Nurse PractitionerMI
-MI
Nurse PractitionerME
Internal MedicineMI
E N D O C R I N O L O G YMI
-MI
-MI
Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal MedicineMI
Internal MedicineMI

Reviews

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Frequently asked questions

How do I look up KENNETH MARK WARDOWSKI (PA) by NPI?
Use NPI 1831190305 when you need to reference KENNETH MARK WARDOWSKI (PA) in forms, claims, or directories.
Is KENNETH MARK WARDOWSKI (PA) currently active in the NPI registry?
CMS-published data lists KENNETH MARK WARDOWSKI (PA) as an active registrant.
What does KENNETH MARK WARDOWSKI (PA) treat or focus on?
Patients typically see KENNETH MARK WARDOWSKI (PA) under the specialty Physician Assistant. Clinical services aligned with this taxonomy classification.
Does KENNETH MARK WARDOWSKI (PA) practice in Michigan?
You will see Southfield, Michigan on file for KENNETH MARK WARDOWSKI (PA) alongside any extra practice locations.
How can I contact KENNETH MARK WARDOWSKI (PA)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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