Individual provider Active NPI

David Brandon Minnick, DO

  • Surgery Physician
  • Kalamazoo, MI
National Provider Identifier
1063616167
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5101016805 Issued in MI
Practice address
601 John St
Suite M-283
Kalamazoo, MI 49007-5341
Phone
(269) 349-7696
Fax
(269) 488-8313
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101016805 MI Primary

Addresses

Primary practice location

601 John St
Suite M-283
Kalamazoo, MI 49007-5341

Mailing address

601 John St
Suite M-283
Kalamazoo, MI 49007-5341
Phone (269) 349-7696

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

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
I20110824000449 MI Practitioner - General Surgery 8527238849 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Michigan State University College of Osteopathic Medicine, 2006
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
283A
Kalamazoo, MI 49007-5341
Phone (269) 349-7696

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)22
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101016805MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital CurrentSince Feb 1, 2015 Accepting new patients
Sparrow Ionia Hospital Surgery CurrentSince Feb 1, 2015 Accepting new patients
Bronson Methodist Hospital CurrentSince Dec 1, 2015 Accepting new patients
Sparrow Ionia Hospital Current Accepting new patients
Sparrow Clinton Hospital CurrentSince Aug 1, 2011 Accepting new patients
Western Michigan University School of Medicine CurrentSince Nov 3, 2014 Accepting new patients
Bronson Battle Creek Hospital CurrentSince May 16, 2019 Accepting new patients
Bronson Battle Creek Hospital Surgery CurrentSince May 16, 2019 Accepting new patients
Bronson Methodist Hospital Past Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

300 North Ave
Battle Creek, MI 49017
Phone (269) 966-8000

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

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

601 John St
Ste M-283
Kalamazoo, MI 49007
Phone (269) 349-7696

1000 Oakland Dr
Kalamazoo, MI 49008
Phone (269) 337-4347

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

1210 W Saginaw St
Lansing, MI 48915
Phone (517) 364-7180

291 W Centre Ave
Portage, MI 49024
Phone (269) 488-8430

901 S Oakland St
Saint Johns, MI 48879
Phone (517) 227-2338

Interoperability endpoints

  • Direct secure messaging: dminnick10659@direct.bronsonhg.org
  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 10

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1063616167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE M-283",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-349-7696",
            "fax_number": "269-488-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE M-283",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-349-7696",
            "fax_number": "269-488-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNICK",
        "first_name": "DAVID",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101016805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.