Individual provider Active NPI

Carolyn Von Maur

  • Family Medicine Physician
  • Portage, MI
National Provider Identifier
1023114477
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101015732 Issued in MI
Practice address
7901 Angling Road
Suite B-201
Portage, MI 49024
Phone
(269) 324-8600
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 5101015732 MI Primary

Addresses

Primary practice location

7901 Angling Road
Suite B-201
Portage, MI 49024

Mailing address

5943 Stadium Drive
Suite 3
Kalamazoo, MI 49009

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
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
I20061107000106 MI Practitioner - Family Practice 9032116975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

601 John St
Box 39
Kalamazoo, MI 49007-5341

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Healthcare CurrentSince Nov 1, 2006 Accepting new patients
Bronson Methodist Hospital CurrentSince Jul 1, 2020 Accepting new patients
Ascension Medical Group Promed Family Medicine CurrentSince Nov 1, 2006 Accepting new patients

Locations

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

5943 Stadium Dr
Ste 3
Kalamazoo, MI 49009
Phone (269) 226-8315

2700 E Centre Ave
Portage, MI 49002
Phone (269) 286-7050

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

7901 Angling Rd
Ste B-201
Portage, MI 49024
Phone (269) 324-8600

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 3

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1023114477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5943 STADIUM DRIVE",
            "address_2": "SUITE 3",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 ANGLING ROAD",
            "address_2": "SUITE B-201",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "49024",
            "telephone_number": "269-324-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON MAUR",
        "first_name": "CAROLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101015732",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Portage, MI

Sources for this page

Verify at the official NPI Registry.