Active NPI
Gary D. Stebelton, M.D.
- Internal Medicine Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301407210
- Practice address
- 2750 E Beltline Ave NE
Grand Rapids, MI 49525-8614 - Phone
- (616) 447-5870
- Fax
- (616) 391-7733
- NPI assigned
- Jul 3, 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301407210 | MI | Primary |
Addresses
Primary practice location
2750 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1004341 | Other | MI | MCLAREN HEALTH PLAN |
| 1102900551 | Other | MI | BCBSM |
| 3414128-10 | Medicaid | MI | |
| 0984252 | Other | MI | HEALTHPLUS COMMERCIAL |
| 200000005890 | Other | MI | PHP COMMERCIAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Michigan State University College of Human Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
121 N Pine River St
Ithaca, MI 48847-1039
Phone (989) 875-5111
Hospital & facility affiliations
- Mymichigan Home Care
- Mymichigan Medical Center Clare
- Mymichigan Medical Center Alma
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mymichigan Medical Center Alma | Current | Accepting new patients | |
| Epmg of Michigan, P.C. | Past | Accepting new patients |
Locations
300 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0104
321 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0957
4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956
4851 E Pickard St
Mt Pleasant, MI 48858
Phone (989) 772-3009
Interoperability endpoints
- gstebelton6970@mymichiganhealth.midirect.net
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Alma, MI
- NPI 1568914422
-
- Emergency Medicine Physician
- Livonia, MI
- NPI 1386688992
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Alma, MI
- NPI 1023097771
-
- General Acute Care Hospital
- Clare, MI
- NPI 1568414589
-
- Home Health Agency
- Midland, MI
- NPI 1639102163
-
- General Acute Care Hospital
- Midland, MI
- NPI 1902841414
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405900800000",
"number": "1215966957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC 845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2750 E BELTLINE AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495258614",
"telephone_number": "616-447-5870",
"fax_number": "616-391-7733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEBELTON",
"first_name": "GARY",
"middle_name": "D.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2014-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301407210",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCLAREN HEALTH PLAN",
"identifier": "1004341",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "1102900551",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3414128-10",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPLUS COMMERCIAL",
"identifier": "0984252",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP COMMERCIAL",
"identifier": "200000005890",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.