Individual provider Active NPI

Gary D. Stebelton, M.D.

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1215966957
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301407210 Issued in MI
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

Updated by the provider on Jul 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1004341OtherMIMCLAREN HEALTH PLAN
1102900551OtherMIBCBSM
3414128-10MedicaidMI
0984252OtherMIHEALTHPLUS COMMERCIAL
200000005890OtherMIPHP 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
Green means eligible to order or refer.

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
Mymichigan Medical Center AlmaGroup PAC ID 3375451404, 140 clinicians

Practice addresses (Care Compare)

121 N Pine River St
Ithaca, MI 48847-1039
Phone (989) 875-5111

Hospital & facility affiliations

  • Mymichigan Home Care Home health agency, Midland, MI, CCN 237015
  • Mymichigan Medical Center Clare Hospital, Clare, MI, CCN 230180
  • Mymichigan Medical Center Alma Hospital, Alma, MI, CCN 230030

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alma Current Accepting new patients
Epmg of Michigan, P.C. PastSince Aug 4, 2024 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 4

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": "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

Verify at the official NPI Registry.