Individual provider Active NPI

Gregory William Beaver, PA-C

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1043739550
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008356 Issued in MI
Practice address
601 John St # 74
Kalamazoo, MI 49007-5341
Phone
(269) 341-8481
Fax
(269) 341-7781
NPI assigned
Sep 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008356 MI Primary

Addresses

Primary practice location

601 John St # 74
Kalamazoo, MI 49007-5341

Mailing address

2775 Portage Rd
Niles, MI 49120-8706

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171011000957 MI Practitioner - Physician Assistant 5597030957 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

601 John St
Kalamazoo, MI 49007-5377

955 S Bailey Ave
Bronson Women'S Services South Have
South Haven, MI 49090-6743
Phone 26963752712301

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital Physician Assistant CurrentSince Nov 5, 2017 Accepting new patients
Bronson Lakeview Hospital CurrentSince Nov 5, 2017 Accepting new patients
Patholgy Services of Kalamazoo, PC Current Accepting new patients

Locations

601 John St
#74
Kalamazoo, MI 49007
Phone (269) 341-8481

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

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

Organizations & group practices 5

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": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1043739550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 PORTAGE RD",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491208706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST # 74",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-8481",
            "fax_number": "269-341-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVER",
        "first_name": "GREGORY",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-15",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.