Individual provider Active NPI

Lee Michael Sterenberg, D.O.

  • Family Medicine Physician
  • Grand Haven, MI
National Provider Identifier
1003811092
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101009998 Issued in MI
Practice address
600 Park Ave
Grand Haven, MI 49417-2173
Phone
(616) 847-8700
Fax
(616) 847-1049
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101009998 MI Primary

Addresses

Primary practice location

600 Park Ave
Grand Haven, MI 49417-2173

Mailing address

600 Park Ave
Grand Haven, MI 49417-2173
Phone (616) 847-8700

Other identifiers 3

IdentifierTypeStateIssuer
3192075MedicaidMA
5190580MedicaidMI
3108080MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061012000072 MI Practitioner - Family PracticePractitioner - General Practice 6800798802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 Park Ave
Suite 4
Grand Haven, MI 49417-2173
Phone (616) 847-8700

Hospital & facility affiliations

  • Trinity Health Grand Haven Hospital Hospital, Grand Haven, MI, CCN 230174
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Health Partners Grand Haven PLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24382/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/AIEHAD/Endpoint/AIEHAD
  • Direct secure messaging: lee.sterenberg.1@24382.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1003811092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PARK AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172173",
            "telephone_number": "616-847-8700",
            "fax_number": "616-847-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PARK AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172173",
            "telephone_number": "616-847-8700",
            "fax_number": "616-847-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERENBERG",
        "first_name": "LEE",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101009998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3192075",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5190580",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3108080",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.