Individual provider Active NPI

Adam Passeno, D.O.

  • Emergency Medicine Physician
  • Wyoming, MI
National Provider Identifier
1053502542
Registry record updated Aug 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5315028124 Issued in MI
Practice address
5900 Byron Center SW
Metro Health Hospital
Wyoming, MI 49519
Phone
(616) 252-7123
NPI assigned
Aug 8, 2007
Last updated
Aug 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2009

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 5315028124 MI Primary

Addresses

Primary practice location

5900 Byron Center SW
Metro Health Hospital
Wyoming, MI 49519

Mailing address

PO Box 2184
Certified Emergency Medicine Specialists PC
Grand Rapids, MI 49501-2184
Phone (616) 363-7867

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
I20070727000788 MI Practitioner - Emergency Medicine 8820199334 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Certified Emergency Medicine Specialists PCGroup PAC ID 6204802895, 14 clinicians

Practice addresses (Care Compare)

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5315028124MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Certified Emergency Medicine Specialists, PC CurrentSince Mar 1, 2009 Accepting new patients
Metropolitan Hospital CurrentSince Feb 2, 2016 Accepting new patients

Locations

4055 Cascade Rd SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 252-4010

4433 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 261-5189

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

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

Hospital & facility affiliations 1

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250812800000",
    "number": "1053502542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2184",
            "address_2": "CERTIFIED EMERGENCY MEDICINE SPECIALISTS PC",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495012184",
            "telephone_number": "616-363-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER SW",
            "address_2": "METRO HEALTH HOSPITAL",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49519",
            "telephone_number": "616-252-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSENO",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2009-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5315028124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.