NPIMap

State of Michigan Office of Financial Management

A Medicare group practice based in Grand Rapids, MI: 9 NPIs enrolled under one PECOS associate control ID (PAC ID 5496650723), with 140 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
5496650723The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Hospital, Part A Provider - Skilled Nursing Facility, Part B Supplier - Clinic/Group Practice
Enrolled in
MI
Enrollments
11
Group size
22 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
15In 7 places

Enrollment records 11

Enrollment IDStateProvider typeNPI
O20040114000603 MI Part B Supplier - Clinic/Group Practice 1508883299
O20040612000494 MI Part B Supplier - Clinic/Group Practice 1710989298
O20040805000056 MI Part A Provider - Hospital 1508883299
O20040805000072 MI Part A Provider - Hospital 1194767996
O20040805000118 MI Part A Provider - Hospital 1194736587
O20060327000260 MI Part B Supplier - Clinic/Group Practice 1710989298
O20100628001128 MI Part A Provider - Hospital 1003859380
O20231218001709 MI Part B Supplier - Clinic/Group Practice 1497342653
O20210804004112 MI Part A Provider - Skilled Nursing Facility 1669046835
O20210709002083 MI Part A Provider - Skilled Nursing Facility 1497342653
O20181023000078 MI Part A Provider - Skilled Nursing Facility 1285604819

NPIs in this group 9

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 140

Page 1 of 2

Clinicians who reassign their Medicare benefits to this group (140) or whom Care Compare lists as members (22).

Sources for this page