Individual provider Active NPI

Jonathan Ross Dadurian, MD

  • Emergency Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1023454832
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301102882 Issued in MI
Practice address
125 S Kalamazoo Mall
Ste 204
Kalamazoo, MI 49007
Phone
(269) 343-3900
NPI assigned
May 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301102882 MI Primary

Addresses

Primary practice location

125 S Kalamazoo Mall
Ste 204
Kalamazoo, MI 49007

Mailing address

125 S Kalamazoo Mall
Ste 204
Kalamazoo, MI 49007
Phone (269) 343-3900

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
I20160802003079 MI Practitioner - Emergency Medicine 4284950478 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwestern Michigan Emergency Services, PCGroup PAC ID 1456265891, 69 clinicians

Practice addresses (Care Compare)

601 John St
Kalamazoo, MI 49007-5341
Phone (269) 341-7654

Hospital & facility affiliations

  • Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Bronson South Haven Hospital Hospital, South Haven, MI, CCN 230085
  • Bronson Lakeview Hospital Hospital, Paw Paw, MI, CCN 231332

Merit-based Incentive Payment System (MIPS)

Final score
93.26 of 100Reported as group
Quality
79.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Jul 1, 2024 Accepting new patients
Southwestern Michigan Emergency Services, PC CurrentSince Jul 1, 2016 Accepting new patients

Locations

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

125 S Kalamazoo Mall
Ste 204
Kalamazoo, MI 49007
Phone (269) 343-3900

940 John St
Kalamazoo, MI 49001
Phone (269) 343-7296

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

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

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 4

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": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1023454832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL",
            "address_2": "STE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49007",
            "telephone_number": "269-343-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL",
            "address_2": "STE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49007",
            "telephone_number": "269-343-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADURIAN",
        "first_name": "JONATHAN",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-20",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301102882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.