Individual provider Active NPI

William Marc Katz, MD

  • Sleep Medicine (Internal Medicine) Physician
  • Wyoming, MI
National Provider Identifier
1013024140
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
4301044867 Issued in MI
Practice address
2093 Health Dr SW
Ste 200
Wyoming, MI 49519
Phone
(616) 459-3158
Fax
(616) 819-2222
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 4301044867 MI
Pulmonary Disease Physician 207RP1001X 4301044867 MI
Sleep Medicine (Internal Medicine) Physician 207RS0012X 4301044867 MI Primary

Addresses

Primary practice location

2093 Health Dr SW
Ste 200
Wyoming, MI 49519

Mailing address

1900 Wealthy St SE
Ste 150
Grand Rapids, MI 49506-2969
Phone (616) 459-3158

Other identifiers 3

IdentifierTypeStateIssuer
1104106031OtherMIBCBS OF MICHIGAN
38-2145264OtherIRS TAX ID# THRU CORP
1896734MedicaidMI

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
I20061219000423 MI Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 8527074376 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301044867MIMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Promed Pulmonary Disease CurrentSince Oct 1, 2011 Accepting new patients
Promed Healthcare CurrentSince Oct 1, 2011 Accepting new patients
Grand Valley Medical Specialists PLC CurrentSince Aug 1, 2002 Accepting new patients
Ascension Medical Group Promed Current Accepting new patients

Locations

1000 East Paris Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 459-3158

1900 Wealthy St SE
Ste 150
Grand Rapids, MI 49506
Phone (616) 459-3158

1717 Shaffer St
Ste 002
Kalamazoo, MI 49048

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

2093 Health Dr SW
Ste 200
Wyoming, MI 49519
Phone (616) 459-3158

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277164800000",
    "number": "1013024140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WEALTHY ST SE",
            "address_2": "STE 150",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062969",
            "telephone_number": "616-459-3158",
            "fax_number": "616-459-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2093 HEALTH DR SW",
            "address_2": "STE 200",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-459-3158",
            "fax_number": "616-819-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "WILLIAM",
        "middle_name": "MARC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2010-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301044867",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301044867",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MI",
            "license": "4301044867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "1104106031",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS TAX ID# THRU CORP",
            "identifier": "38-2145264",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1896734",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.