Individual provider Active NPI

Joshua Mark Kuperus

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1235923921
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4351054560 Issued in MI
Practice address
25 Michigan St NE Ste 2100
Grand Rapids, MI 49503-2526
Phone
(616) 391-3777
NPI assigned
Apr 7, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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 4351054560 MI Primary

Addresses

Primary practice location

25 Michigan St NE Ste 2100
Grand Rapids, MI 49503-2526

Mailing address

25 Michigan St NE Ste 2100
Grand Rapids, MI 49503-2526
Phone (616) 391-3777

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
I20250606003343 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8325558547

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1235923921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MICHIGAN ST NE STE 2100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032526",
            "telephone_number": "616-391-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MICHIGAN ST NE STE 2100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032526",
            "telephone_number": "616-391-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPERUS",
        "first_name": "JOSHUA",
        "middle_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351054560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.