Norbert Paul Gerondale, M.D.
Individual provider Active NPI Internal Medicine Physician · Spring Lake, MI
NPI 1235152158 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1235152158
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 4301405952 (MI)
- Practice address
- 17210 Van Wagoner Rd
Spring Lake, MI 49456-9702 - Phone
- (616) 604-6040
- Fax
- (616) 604-6046
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110609000575 | OR | Order and Referring Only - Internal Medicine |
8820042864 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301405952 | MI | MD | Internal Medicine Physician |
Interoperability endpoints
- ngeronda@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301405952 | MI | Yes |
Addresses
Primary practice location
17210 Van Wagoner Rd
Spring Lake, MI 49456-9702
Mailing address
5136 W McMillan Rd
Muskegon, MI 49445-9638
Phone (231) 766-5965
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1107010721 | Other | MI | BLUE CROSS BLUE SHEILD |
Other providers in Spring Lake, MI
- Jennifer Rose French
- Mackenzie Fricke
- John E. Garrison
- Cori J Geoghan
- Andrew Gerlach
- Jacob Rockwell Giddings
- David Michael Giroux
- Gleason Chiropractic Center
- Daniel Clarence Gleason
- Graces House
All providers in Spring Lake, MI · Internal Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.