Individual provider Active NPI

Mark E Meyer, M.D.

  • Neurological Surgery Physician
  • Kalamazoo, MI
National Provider Identifier
1104806678
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4301056522 Issued in MI
Practice address
1541 Gull Rd
Suite 200
Kalamazoo, MI 49048-1639
Phone
(269) 343-1264
Fax
(269) 343-9555
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 4301056522 MI Primary

Addresses

Primary practice location

1541 Gull Rd
Suite 200
Kalamazoo, MI 49048-1639

Mailing address

1541 Gull Rd
Suite 200
Kalamazoo, MI 49048-1639
Phone (269) 343-1264

Other identifiers 1

IdentifierTypeStateIssuer
2654120MedicaidMI

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
I20050805000625 MI Practitioner - Neurosurgery 4082526496 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Healthcare CurrentSince Oct 1, 2011 Accepting new patients
Ascension Medical Group Promed Current Accepting new patients
Ascension Medical Group Promed CurrentSince Oct 1, 2011 Accepting new patients

Locations

1717 Shaffer St
Ste 229
Kalamazoo, MI 49048
Phone (269) 381-0764

1717 Shaffer St
Ste 124
Kalamazoo, MI 49048
Phone (269) 226-5456

3025 Gull Rd
Kalamazoo, MI 49048
Phone (269) 343-1264

1541 Gull Rd
Ste 200
Kalamazoo, MI 49048
Phone (269) 343-1264

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104806678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 GULL RD",
            "address_2": "SUITE 200",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481639",
            "telephone_number": "269-343-1264",
            "fax_number": "269-343-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 GULL RD",
            "address_2": "SUITE 200",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481639",
            "telephone_number": "269-343-1264",
            "fax_number": "269-343-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301056522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2654120",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.