Individual provider Active NPI

Steven Kurt Waskiewicz, NP

  • Family Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1275894958
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704260413 Issued in MI
Practice address
125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832
Phone
(269) 343-3900
Fax
(269) 343-5640
NPI assigned
May 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704260413 MI Primary

Addresses

Primary practice location

125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832

Mailing address

125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832
Phone (269) 343-3900

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121211000206 MI Practitioner - Nurse Practitioner 7113179599 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lansing Urgent Care PLCGroup PAC ID 7214947902, 42 clinicians

Practice addresses (Care Compare)

505 N Clippert St
Lansing, MI 48912-4701
Phone (517) 333-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704260413MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lansing Urgent Care PLC CurrentSince Oct 12, 2021 Accepting new patients
Bronson Methodist Hospital Family CurrentSince Dec 1, 2015 Accepting new patients
Southwestern Michigan Emergency Services, PC CurrentSince Oct 3, 2012 Accepting new patients
Bronson Methodist Hospital Past Accepting new patients
Lansing Urgent Care, PLC PastSince Oct 12, 2021 Accepting new patients

Locations

555 Linn St
Allegan, MI 49010
Phone (269) 673-8424

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

125 S Kalamazoo Mall
Ste 204
Kalamazoo, MI 49007
Phone (269) 343-3900

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

505 N Clippert St
Lansing, MI 48912
Phone (517) 285-0905

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

5121 S Westnedge Ave
Portage, MI 49002
Phone (269) 337-2110

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1275894958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL",
            "address_2": "SUITE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074832",
            "telephone_number": "269-343-3900",
            "fax_number": "269-343-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL",
            "address_2": "SUITE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074832",
            "telephone_number": "269-343-3900",
            "fax_number": "269-343-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASKIEWICZ",
        "first_name": "STEVEN",
        "middle_name": "KURT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-30",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704260413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.