Maxwell McDonald Jr.
Individual provider Active NPI Family Medicine Physician · Coopersville, MI
NPI 1255759031 · NPPES record last updated Mar 3, 2021
Key facts
- NPI
- 1255759031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5101020884 (MI)
- Practice address
- 25 Conran Dr Ste B
Coopersville, MI 49404-1366 - Phone
- (616) 267-7860
- NPI assigned
- Mar 31, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Michigan State University College of Osteopathic Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Spectrum Health Primary Care Partners
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
Hospital & facility affiliations
- Spectrum Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- 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 |
|---|---|---|---|---|
| I20170714002799 | MI | Practitioner - Family Practice | 8527280056 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Current |
Accepting new patients | |
| Spectrum Health Primary Care Partners | Current |
Accepting new patients |
Locations
25 Conran Dr
Ste B
Coopersville, MI 49404
Phone (616) 267-7860
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
Interoperability endpoints
- mmcdonald157438@epic00.shdirect.org
- mmcdonaldjr157438@epic00.corewelldirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101020884 | MI | Yes |
Addresses
Primary practice location
25 Conran Dr Ste B
Coopersville, MI 49404-1366
Mailing address
100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mmcdonald157438@epic00.shdirect.org | ||
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/ |
Other providers in Coopersville, MI
- Alysha Kropewnicki
- Corey Wayne Kuipers
- Albert J Lafleur
- Peter Lin
- Jacob Colbert Lueder
- Katie Anne McNitt
- Laura Mervenne
- Ardwan Meshaal
- Michigan Medical Patient Care
- Janet Marie Millermaier
All providers in Coopersville, MI · Family 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 Mar 3, 2021. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.