Arcadia Family Health PLLC
Organization Active NPI Family Medicine Physician · Saint Joseph, MI
NPI 1265183248 · NPPES record last updated Apr 25, 2022
Key facts
- NPI
- 1265183248
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ARCADIA FAMILY HEALTH PLLC
- Practice address
- 3901 Stonegate Park Ste F
Saint Joseph, MI 49085-9137 - Phone
- (810) 624-1586
- NPI assigned
- Jan 12, 2022
- Organization subpart
- No
Authorized official
- Name
- Ryan S Klanseck, DO
- Title
- Owner
- Phone
- (810) 624-1586
Practitioners 1
-
Ryan Stephen Klanseck, D.O.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2260765 | Arcadia Family Health PLLC | Certificate of waiver | May 22, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220204001407 | MI | Part B Supplier - Clinic/Group Practice | 6002209509 |
Receives reassigned benefits from 1 practitioner Practice locations: Saint Joseph, MI |
National Provider Directory
Locations
3901 Stonegate Park
Ste F
Saint Joseph, MI 49085
Phone (810) 624-1586
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
3901 Stonegate Park Ste F
Saint Joseph, MI 49085-9137
Mailing address
3901 Stonegate Park Ste F
Saint Joseph, MI 49085-9137
Phone (810) 624-1586
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811195712 | Medicaid | MI |
Other names
- Arcadia Family Health PLLC
Other providers in Saint Joseph, MI
- Kathleen M Andries
- Anjana Gupta, DDS, PLLC
- Anne Carptener PHD PLC
- Apex Physical Therapy & Wellness LLC
- Bijan Jordan Arab
- Arcadia Home Oxygen & Medical Equipment
- Suzanne Arlene Arendt
- Kendria L Armstrong-Andrews
- Fabian Jorge Arnaldo
- Brian Larry Kim Arny
All providers in Saint Joseph, 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 Apr 25, 2022. 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.
- 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.