Individual provider Active NPI

Bernard Kent Maupin, M.D.

  • Orthopaedic Hand Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1194783936
Registry record updated Mar 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
4301043303 Issued in MI
Practice address
1111 Leffingwell Ave NE
Suite 200
Grand Rapids, MI 49525-6406
Phone
(616) 459-7101
Fax
(616) 954-9871
NPI assigned
May 2, 2006
Last updated
Mar 12, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X 4301043303 MI Primary

Addresses

Primary practice location

1111 Leffingwell Ave NE
Suite 200
Grand Rapids, MI 49525-6406

Mailing address

1111 Leffingwell Ave NE
Suite 200
Grand Rapids, MI 49525-6406
Phone (616) 459-7101

Other identifiers 1

IdentifierTypeStateIssuer
3152810MedicaidMI

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
I20061107000478 MI Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 5799782678 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Grand Rapids, PC Current Accepting new patients
Metropolitan Hospital Current Accepting new patients
Metropolitan Hospital CurrentSince Jan 8, 2018 Accepting new patients
Michigan Hand Center, PLC Past Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

1111 Leffingwell Ave NE
Grand Rapids, MI 49525
Phone 61645971011381

1111 Leffingwell Ave NE
Ste 100
Grand Rapids, MI 49525
Phone 61645971011381

1111 Leffingwell Ave NE
Ste 200
Grand Rapids, MI 49525
Phone (616) 956-1101

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

781 36th St SE
Wyoming, MI 49548
Phone (616) 252-4100

Interoperability endpoints

  • Direct secure messaging: bernard.maupin.p1@direct.oam.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363046400000",
    "number": "1194783936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-459-7101",
            "fax_number": "616-957-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-459-7101",
            "fax_number": "616-954-9871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUPIN",
        "first_name": "BERNARD",
        "middle_name": "KENT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2013-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "MI",
            "license": "4301043303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3152810",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.