NPIMap

Organization Active NPI

Bronson Methodist Hospital

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1013089820
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
BRONSON METHODIST HOSPITAL
Practice address
6220 W Main St
Kalamazoo, MI 49009-8925
Phone
(269) 552-4212
NPI assigned
Nov 15, 2006
Organization subpart
Yes
Parent organization
BRONSON METHODIST HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Authorized official

Name
Rebecca East
Title
SVP, Cfo
Phone
(269) 341-6000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207P00000X
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X Primary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

6220 W Main St
Kalamazoo, MI 49009-8925

Mailing address

301 John St
Box 42
Kalamazoo, MI 49007-5295
Phone (269) 341-7806

Other identifiers 1

IdentifierTypeStateIssuer
420C910610OtherMIBCBSM GROUP PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804000437 MI Part B Supplier - Clinic/Group Practice 0244148633 Receives reassigned benefits from 63 practitioners
Practice locations: Kalamazoo, MI

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Emo J W MD

Practitioners & affiliated clinicians

Practitioners 68

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1013089820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 JOHN ST",
            "address_2": "BOX 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075295",
            "telephone_number": "269-341-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 W MAIN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098925",
            "telephone_number": "269-552-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONSON METHODIST HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRONSON METHODIST HOSPITAL",
        "enumeration_date": "2006-11-15",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "EAST",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "SVP, CFO",
        "authorized_official_telephone_number": "269-341-6000"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP PIN",
            "identifier": "420C910610",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.