Individual provider Active NPI

Kevin Gregory-Go Belen, M.D.

  • Emergency Medicine Physician
  • Fairfield, OH
National Provider Identifier
1033452347
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
128301 Issued in OH
Practice address
3000 Mack Rd
Fairfield, OH 45014-5335
Phone
(513) 870-7000
NPI assigned
Apr 4, 2013
Last updated
Oct 6, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 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 128301 OH Primary

Addresses

Primary practice location

3000 Mack Rd
Fairfield, OH 45014-5335

Mailing address

3000 Mack Rd
Fairfield, OH 45014-5335
Phone (513) 870-7000

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
I20220630002720 MI Practitioner - Emergency Medicine 9032409826 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Eastern Virginia Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Observation Medicine Group PLLCGroup PAC ID 6305001777, 29 clinicians
Ihp Mi Emergency Medicine PLLCGroup PAC ID 2365821634, 42 clinicians

Practice addresses (Care Compare)

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (810) 606-5733

6245 Inkster Rd
Garden City, MI 48135-4001
Phone (734) 458-3300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.83 of 100Reported as group
Quality
88.63
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
128301OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Observation Medicine Group PLLC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Emergency Medicine Physicians of Genesee County, PLLC Emergency Medicine CurrentSince Oct 1, 2022 Accepting new patients
Ihp Mi Emergency Medicine PLLC Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients

Locations

6245 Inkster Rd
Garden City, MI 48135
Phone (734) 421-3300

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

2601 Electric Ave
Port Huron, MI 48060
Phone (810) 216-1500

35700 Warren Rd
Westland, MI 48185
Phone (313) 828-5000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1033452347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145335",
            "telephone_number": "513-870-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MACK RD",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145335",
            "telephone_number": "513-870-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELEN",
        "first_name": "KEVIN",
        "middle_name": "GREGORY-GO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "128301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.