NPIMap

Individual provider Active NPI

Randal Baker, MD

  • Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1104867480
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301057752 Issued in MI
Practice address
2060 E Paris Ave SE
Suite 100
Grand Rapids, MI 49546-6113
Phone
(616) 956-6100
Fax
(616) 956-6637
NPI assigned
Jun 9, 2006
Last updated
Jun 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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 4301057752 MI Primary

Addresses

Primary practice location

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

Mailing address

2060 E Paris Ave SE
Suite 100
Grand Rapids, MI 49546-6113
Phone (616) 956-6657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090127000438 MI Practitioner - General Surgery 3173687704 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Albany Medical College of Union University, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Midwest Institute of Health PCGroup PAC ID 2466516091, 13 clinicians
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-5000

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

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux41

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Jul 1, 2014 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Holland Community Hospital Current Accepting new patients
Metropolitan Hospital CurrentSince May 1, 2017 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Jul 1, 2014 Accepting new patients
Metropolitan Hospital Past Accepting new patients
Saint Mary's Health Services Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

2060 East Paris Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 464-4620

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

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

Organizations & group practices 8

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 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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1104867480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 E PARIS AVE SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466113",
            "telephone_number": "616-956-6657",
            "fax_number": "616-956-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 E PARIS AVE SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466113",
            "telephone_number": "616-956-6100",
            "fax_number": "616-956-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "RANDAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301057752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.