Active NPI
Steven M Konicki, DO
- Family Medicine Physician
- Kalamazoo, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101015464
- Practice address
- 5973 Beatrice Drive
Kalamazoo, MI 49009 - Phone
- (269) 286-7110
- Fax
- (269) 286-7111
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101015464 | MI | Primary |
Addresses
Primary practice location
5973 Beatrice Drive
Kalamazoo, MI 49009
Mailing address
1717 Shaffer St Ste 2
Kalamazoo, MI 49048-1623
Phone (269) 552-2836
Other practice location 1
7901 Angling Rd
Portage, MI 49024-0714
Phone (269) 324-8600
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Michigan State University College of Osteopathic Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
601 S St
Suite 131
Three Rivers, MI 49093-2146
Phone (269) 286-7070
Hospital & facility affiliations
- Bronson Methodist Hospital
- Bronson Lakeview Hospital
- Three Rivers Health
- Borgess Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101015464 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bronson Methodist Hospital | Current | Accepting new patients | |
| Promed Healthcare | Current | Accepting new patients | |
| Ascension Medical Group Promed | Family Medicine | Current | Accepting new patients |
Locations
601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100
5973 Beatrice Dr
Kalamazoo, MI 49009
Phone (269) 286-7110
1717 Shaffer St
Ste 2
Kalamazoo, MI 49048
601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500
7901 Angling Rd
Ste B-201
Portage, MI 49024
Phone (269) 324-8600
7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405
Interoperability endpoints
- direct@direct.bronsonhg.org
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.
-
- Hospitalist Physician
- Kalamazoo, MI
- NPI 1417961137
-
- Family Medicine Physician
- Portage, MI
- NPI 1497709869
-
- Rural Health Clinic/Center
- Plainwell, MI
- NPI 1487708830
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kalamazoo, MI
- NPI 1568416311
-
- Critical Access Hospital
- Paw Paw, MI
- NPI 1962508259
-
- General Acute Care Hospital
- Kalamazoo, MI
- NPI 1831116441
-
- General Acute Care Hospital
- Three Rivers, MI
- NPI 1568739423
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1164512034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 SHAFFER ST STE 2",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490481623",
"telephone_number": "269-552-2836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5973 BEATRICE DRIVE",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "49009",
"telephone_number": "269-286-7110",
"fax_number": "269-286-7111"
}
],
"practiceLocations": [
{
"address_1": "7901 Angling Rd",
"address_purpose": "LOCATION",
"city": "Portage",
"state": "MI",
"postal_code": "490240714",
"country_code": "US",
"telephone_number": "269-324-8600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KONICKI",
"first_name": "STEVEN",
"middle_name": "M",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2023-11-27",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101015464",
"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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.