Individual provider Active NPI

Austin Alan Poulson

  • Emergency Medicine Physician
  • Muskegon, MI
National Provider Identifier
1174268494
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
9126988-1204 Issued in UT
Practice address
1675 Leahy St Ste 201
Muskegon, MI 49442-5542
Phone
(231) 672-8289
NPI assigned
May 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 9126988-1204 UT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1675 Leahy St Ste 201
Muskegon, MI 49442-5542

Mailing address

1675 Leahy St Ste 201
Muskegon, MI 49442-5542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250211000558 MI Practitioner - Emergency Medicine 2769912435 Reassigns benefits to 3 organizations
I20250922002736 UT Practitioner - Emergency Medicine 2769912435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Michigan Emergency Specialists, PLLCGroup PAC ID 0749569242, 36 clinicians
West Emergency Services LLCGroup PAC ID 1850785296, 16 clinicians

Practice addresses (Care Compare)

1500 E Sherman Blvd
Mercy Campus
Muskegon, MI 49444-1849
Phone (231) 728-4601

300 N Hospital Dr
Price, UT 84501-4218
Phone (435) 637-4800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Michigan Observation Services PLLC CurrentSince Jul 1, 2025 Accepting new patients
West Emergency Services, LLC Emergency Medicine CurrentSince Sep 1, 2025 Accepting new patients
Mercy Health Partners CurrentSince Dec 7, 2024 Accepting new patients
Lake Michigan Emergency Specialists, PLLC Emergency Medicine CurrentSince Jul 1, 2025 Accepting new patients
Mercy Health Partners CurrentSince Dec 7, 2024 Accepting new patients

Locations

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

71 Bevier St
Shelby, MI 49455
Phone (231) 861-2172

72 S State St
Shelby, MI 49455
Phone (231) 728-4601

905 E Colby St
Whitehall, MI 49461
Phone (231) 672-8050

300 N Hospital Dr
Price, UT 84501
Phone (435) 636-4836

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1174268494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST STE 201",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST STE 201",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425542",
            "telephone_number": "231-672-8289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSON",
        "first_name": "AUSTIN",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-02",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "9126988-1204",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.