Individual provider Active NPI

Evan Connor Kowalski, MD

  • Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1073174108
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301506958 Issued in MI
Practice address
2060 E Paris Ave SE Ste 100
Grand Rapids, MI 49546-6113
Phone
(616) 956-6100
NPI assigned
Jun 28, 2019
Last updated
Mar 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35.150576 OH
Surgery Physician 208600000X 4301506958 MI Primary

Addresses

Primary practice location

2060 E Paris Ave SE Ste 100
Grand Rapids, MI 49546-6113

Mailing address

2060 E Paris Ave SE Ste 100
Grand Rapids, MI 49546-6113
Phone (616) 956-6100

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
I20250818003620 MI Practitioner - General Surgery 2668701889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wayne State University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Institute of Health PCGroup PAC ID 2466516091, 13 clinicians

Practice addresses (Care Compare)

2060 E Paris Ave SE
Suite 100
Grand Rapids, MI 49546-6113
Phone (616) 956-6100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Surgery CurrentSince Jul 24, 2025 Accepting new patients
Summa Physicians LLC Current Accepting new patients
Memorial Hospital CurrentSince Jul 24, 2025 Accepting new patients
Midwest Institute of Health PC Surgery Past Accepting new patients
Summa Health System Past Accepting new patients

Locations

113 E Williams St
Owosso, MI 48867
Phone (989) 725-6101

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

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

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": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1073174108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 E PARIS AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466113",
            "telephone_number": "616-956-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 E PARIS AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466113",
            "telephone_number": "616-956-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "EVAN",
        "middle_name": "CONNOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-28",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.150576",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301506958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.