Active NPI
Stephen Todd Wysong, M.D.
- Vascular Surgery Physician
- Kalamazoo, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 4301058092
- Practice address
- 601 John St
Suite M-283
Kalamazoo, MI 49007-5341 - Phone
- (269) 349-7696
- Fax
- (269) 349-0610
- NPI assigned
- Jun 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301058092 | MI | |
| Vascular Surgery Physician | 2086S0129X | 4301058092 | MI | Primary |
Addresses
Primary practice location
601 John St
Suite M-283
Kalamazoo, MI 49007-5341
Mailing address
601 John St
Box 42
Kalamazoo, MI 49007-5341
Phone (269) 349-7696
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3279453-10 | Medicaid | MI | |
| 3403903000 | Other | MI | BCBS IND PIN |
| 112048 | Other | GREAT LAKES HLTH PLN | |
| 5898515 | Other | AETNA PIN | |
| 020C91020 | Other | MI | BCBS GRP PIN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct@direct.bronsonhg.org | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Wayne State University School of Medicine, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
601 John St
Kalamazoo, MI 49007-5341
601 John St
Kalamazoo, MI 49007-5377
Hospital & facility affiliations
- Bronson Methodist Hospital
- Bronson Lakeview Hospital
- Bronson Battle Creek Hospital
- Bronson South Haven Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.43 of 100
- Quality
- 75.38
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.38
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bronson Methodist Hospital | Current | Accepting new patients | |
| Healthcare Midwest PC | Surgery | Past | Accepting new patients |
| Western Michigan University School of Medicine | Past | Accepting new patients | |
| Michigan State University Kalamazoo Center for Medical Studies | Past | Accepting new patients |
Locations
1000 Oakland Dr
Kalamazoo, MI 49008
Phone (269) 337-4347
601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500
601 John St
Ste M-283
Kalamazoo, MI 49007
Phone (269) 349-7696
601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806
601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100
291 W Centre Ave
Portage, MI 49024
Phone (269) 488-8430
Interoperability endpoints
- direct@direct.bronsonhg.org
- swysong10865@direct.bronsonhg.org
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.
-
- Hospitalist Physician
- Kalamazoo, MI
- NPI 1417961137
-
- Surgery Physician
- Kalamazoo, MI
- NPI 1245451129
-
- Multi-Specialty Clinic/Center
- Kalamazoo, MI
- NPI 1568467249
-
- Multi-Specialty Clinic/Center
- Kalamazoo, MI
- NPI 1316212343
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Battle Creek, MI
- NPI 1083644579
-
- Critical Access Hospital
- Paw Paw, MI
- NPI 1962508259
-
- General Acute Care Hospital
- Kalamazoo, MI
- NPI 1831116441
-
- General Acute Care Hospital
- South Haven, MI
- NPI 1346275856
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1013952985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 JOHN ST",
"address_2": "BOX 42",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490075341",
"telephone_number": "269-349-7696",
"fax_number": "269-349-0610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 JOHN ST",
"address_2": "SUITE M-283",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490075341",
"telephone_number": "269-349-7696",
"fax_number": "269-349-0610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYSONG",
"first_name": "STEPHEN",
"middle_name": "TODD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-17",
"last_updated": "2023-11-27",
"certification_date": "2020-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301058092",
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MI",
"license": "4301058092",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3279453-10",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IND PIN",
"identifier": "3403903000",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT LAKES HLTH PLN",
"identifier": "112048",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PIN",
"identifier": "5898515",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GRP PIN",
"identifier": "020C91020",
"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 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.