Individual provider Active NPI

Evan Pasternak, DO

  • Emergency Medicine Physician
  • Wyoming, MI
National Provider Identifier
1235712977
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101027447 Issued in MI
Practice address
5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone
(616) 252-7200
Fax
(616) 252-4953
NPI assigned
Apr 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101027447 MI Primary

Addresses

Primary practice location

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Mailing address

1840 Wealthy St SE
Grand Rapids, MI 49506-2921
Phone (616) 391-1730

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240716004507 MI Practitioner - Emergency Medicine 9931501293 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visionary Medical Services, PCGroup PAC ID 1951404185, 63 clinicians
Ecs Western Michigan PCGroup PAC ID 8628327384, 202 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 391-1730

1840 Wealthy St SE
Grand Rapids, MI 49506-2921
Phone (616) 391-1730

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Corewell Health Pennock Hospital Hospital, Hastings, MI, CCN 231339
  • Corewell Health Zeeland Hospital Hospital, Zeeland, MI, CCN 230003
  • Corewell Health Ludington Hospital Hospital, Ludington, MI, CCN 230110

Merit-based Incentive Payment System (MIPS)

Final score
97.48 of 100Reported as group
Quality
89.26
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Visionary Medical Services PC Emergency Medicine CurrentSince May 10, 2024 Accepting new patients
Ecs Western Michigan PC Emergency Medicine CurrentSince May 10, 2024 Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

1840 Wealthy St SE
Grand Rapids, MI 49506
Phone (616) 391-1730

615 S Bower St
Greenville, MI 48838
Phone (616) 754-4341

1009 W Green St
Hastings, MI 49058
Phone (269) 945-1212

Organizations & group practices 3

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": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1235712977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062921",
            "telephone_number": "616-391-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7200",
            "fax_number": "616-252-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTERNAK",
        "first_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-30",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101027447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.