Susan L Mastenbrook, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704207644 Issued in MI

Practice address

1521 Gull Rd
Kalamazoo, MI 49048-1640

Phone

(269) 226-7000

NPI assigned

Apr 27, 2012

Last updated

Dec 27, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Beacon Medical Group Michigan Inc

  dba Beacon Medical Group Michigan

  • Family Medicine Physician
  • Portage, MI
  • NPI 1497709869
  Medicare reassignment Care Compare group NPD
• Beacon Kalamazoo Inc

  dba Beacon Kalamazoo

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Medicare reassignment NPD
• Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Kalamazoo, MI
  • NPI 1811065576
  Medicare reassignment NPD
• Beacon Kalamazoo Inc

  dba Borgess Inpatient Services

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1093749848

  Nurse Practitioner

  NPD
• Beacon Kalamazoo Inc

  dba Beacon Kalamazoo

  • Diagnostic Radiology Physician
  • Kalamazoo, MI
  • NPI 1518753441
  NPD
• Beacon Medical Group Michigan Inc

  dba Beacon Medical Group Michigan

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1720009954

  Family

  NPD
• Family Health Center Inc

  dba Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Kalamazoo, MI
  • NPI 1215768296
  NPD
• Promed Healthcare

  dba Borgess Women's Health

  • Rural Health Clinic/Center
  • Plainwell, MI
  • NPI 1487708830
  NPD
• Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kalamazoo, MI
  • NPI 1023560331
  NPD (past)
• Family Health Center, Inc.

  dba Family Health Center - Burdick

  • Federally Qualified Health Center (FQHC)
  • Kalamazoo, MI
  • NPI 1891005906
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beacon Kalamazoo Inc

  dba Beacon Kalamazoo

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Care Compare affiliation

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1205194248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5943 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481640",
            "telephone_number": "269-226-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 W Paterson St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490072581",
            "country_code": "US",
            "telephone_number": "269-349-2641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTENBROOK",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704207644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cara Masselink
• Chardae Massey
• Aaron Mastenbrook
• Anna Mastenbrook
• Joshua Dean Mastenbrook, MD
• Lynnette Matar, MA LPC NCC LLP
• Paige Materi, BSW
• Maternal Infant Health Program
• Heather Lyn Matheny, P.A.-C
• Nina A Mathew, MD

• Family Nurse Practitioner in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.

Verify at the official NPI Registry.