NPIMap

Organization Active NPI

Ascension Genesys Hospital

Doing business as Genesys Pediatric Hospitalist

  • Pediatrics Physician
  • Grand Blanc, MI
National Provider Identifier
1225349699
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ASCENSION GENESYS HOSPITAL
Doing business as
Genesys Pediatric Hospitalist
Practice address
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone
(810) 606-5000
NPI assigned
Jun 30, 2010
Last updated
Mar 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Authorized official

Name
Josephine Herman
Title
Director Physician Services
Phone
(810) 606-5893

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary
Pediatric Cardiology Physician 2080P0202X NU

Addresses

Primary practice location

1 Genesys Pkwy
Grand Blanc, MI 48439-8065

Mailing address

5445 Ali Dr
Grand Blanc, MI 48439-5191
Phone (810) 695-9982

Other names 1

  • Genesys Pediatric Hospitalist Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031208000842 MI Part B Supplier - Clinic/Group Practice 2062323033 Receives reassigned benefits from 102 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Blanc, MI; Flint, MI; Burton, MI

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Benjamin Burroughs PA37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1225349699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 ALI DR",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484395191",
            "telephone_number": "810-695-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION GENESYS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-30",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "JOSEPHINE",
        "authorized_official_title_or_position": "DIRECTOR PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "810-606-5893"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesys Pediatric Hospitalist",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Genesys Pediatric Hospitalist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.