Kenneth Grant Masters, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Detroit, Michigan. He went to Michigan State University College Of Osteopathic Medicine and graduated in 2020 and has 5 years of diverse experience with area of expertise as Anesthesiology. He is a member of the group practice Northstar Anesthesia Of Michigan Pllc and 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
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1295355063.
Physician's Profile
| Full Name | Kenneth Grant Masters |
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| Gender | Male |
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| Speciality | Anesthesiology |
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| Experience | 5 Years |
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| Location | 4201 Saint Antoine St, Detroit, Michigan |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Kenneth Grant Masters attended and graduated from Michigan State University College Of Osteopathic Medicine in 2020
NPI Data:
- NPI Number: 1295355063
- Provider Enumeration Date: 04/22/2020
- Last Update Date: 08/05/2025
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 |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Northstar Anesthesia Of Michigan Pllc | 9638481591 | 172 |
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 | 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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