Randal Baker, MD
Individual provider Active NPI Surgery Physician · Grand Rapids, MI
NPI 1104867480 · NPPES record last updated Jun 28, 2013
Key facts
- NPI
- 1104867480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 4301057752 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 4
Medicare Care Compare profile
- 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
- Advantage Health/Saint Mary'S Medical Group
Midwest Institute of Health PC
Metropolitan Hospital
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
- Mercy Health Saint Mary'S
- Spectrum Health
- University of Michigan Health - West
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 41 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090127000438 | MI | Practitioner - General Surgery | 3173687704 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advantage Health/Saint Mary'S Medical Group | Current | Accepting new patients | |
| Advantage Health Saint Mary'S Medical Group | Current |
Accepting new patients | |
| Advantage Health Saint Mary'S Medical Group | Current |
Accepting new patients | |
| Metropolitan Hospital | Current |
Accepting new patients | |
| Holland Community Hospital | Current | 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
2060 East Paris Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 464-4620
200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000
602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350
5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 4301057752 | MI | Yes |
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
Other providers in Grand Rapids, MI
- Maya Louise Cron Baker
- Nancy Jo Baker
- Nicole Renee Baker
- Nipaporn Baker
- Nithya Nagaraj Baker
- Rosalyn Baker
- Sara Marie Baker
- Sarah Catherine Baker
- Susan L Baker
- Rebecca Bakken
All providers in Grand Rapids, MI · Surgery Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.