Individual provider Active NPI

Elizabeth Neubig, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1043263544
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301054925 Issued in MI
Practice address
200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone
(616) 685-1835
Fax
(616) 685-1846
NPI assigned
May 18, 2006
Last updated
Aug 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301054925 MI Primary

Addresses

Primary practice location

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502

Mailing address

245 State St SE
Ste 228
Grand Rapids, MI 49503-4328
Phone (616) 685-1808

Other identifiers 2

IdentifierTypeStateIssuer
4502459MedicaidMI
4545699MedicaidMI

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
I20100806000014 MI Practitioner - Internal Medicine 2567595887 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Jul 1, 2010 Accepting new patients
Saint Mary's Health Services Internal Medicine CurrentSince Jun 12, 2018 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Saint Mary's Health Services CurrentSince Jun 12, 2018 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Jul 1, 2010 Accepting new patients
Advantage Health Physicians PC Internal Medicine Past Accepting new patients
Trinity Health - Michigan Past Accepting new patients
Computer Health Services PC PastSince Mar 1, 2000 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

245 State St SE
Ste 1A
Grand Rapids, MI 49503

245 State St SE
Ste 228
Grand Rapids, MI 49503

260 Jefferson Ave SE
Ste 206
Grand Rapids, MI 49503
Phone (616) 752-5432

3380 44th St SW
Grandville, MI 49418
Phone (616) 685-8250

1900 44th St SE
Kentwood, MI 49508
Phone (616) 685-8500

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

Interoperability endpoints

  • Direct secure messaging: eneubig27452@direct.trinity-health.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1043263544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 STATE ST SE",
            "address_2": "STE 228",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034328",
            "telephone_number": "616-685-1808",
            "fax_number": "616-685-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-685-1835",
            "fax_number": "616-685-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUBIG",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301054925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4502459",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4545699",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.