Individual provider Active NPI

Michael Merle Samborn, DO

  • Emergency Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1285209742
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101027136 Issued in MI
Practice address
1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone
(269) 337-4600
NPI assigned
May 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5151015030 MI
Emergency Medicine Physician 207P00000X 5101027136 MI Primary

Addresses

Primary practice location

1000 Oakland Dr
Kalamazoo, MI 49008-1282

Mailing address

1000 Oakland Dr
Kalamazoo, MI 49008-1282

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
I20230518002089 MI Practitioner - Emergency Medicine 5890197149 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians
Mymichigan Medical Center ClareGroup PAC ID 7012829773, 128 clinicians

Practice addresses (Care Compare)

4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250

703 N McEwan St
Clare, MI 48617-1440
Phone (989) 802-5120

Hospital & facility affiliations

  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
  • Mymichigan Medical Center Gladwin Hospital, Gladwin, MI, CCN 231325
  • Mymichigan Medical Center Clare Hospital, Clare, MI, CCN 230180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101027136MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Vituity-Michigan Health Services PC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Mymichigan Medical Center Gladwin Current Accepting new patients
Mymichigan Medical Center Midland Emergency Medicine CurrentSince May 16, 2024 Accepting new patients
Mymichigan Medical Center Gladwin Emergency Medicine CurrentSince Aug 15, 2024 Accepting new patients
Vituity-Michigan Health Services PC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Mymichigan Medical Center Midland CurrentSince May 16, 2024 Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Aug 15, 2024 Accepting new patients
Mymichigan Medical Center Gladwin Current Accepting new patients
Mymichigan Medical Center Clare CurrentSince Aug 15, 2024 Accepting new patients
Mymichigan Medical Center Clare Emergency Medicine CurrentSince Aug 15, 2024 Accepting new patients
Mymichigan Medical Center Clare Current Accepting new patients
Mymichigan Medical Center Midland Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3051 Kiesel Rd
Bay City, MI 48706
Phone (989) 778-2888

703 N McEwan St
Clare, MI 48617
Phone (989) 802-5000

420 W High St
Dowagiac, MI 49047
Phone (269) 782-8681

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

411 Naomi St
Plainwell, MI 49080
Phone (269) 685-0700

4599 Towne Centre Rd
Saginaw, MI 48604
Phone (989) 497-3000

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 5

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": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1285209742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 OAKLAND DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OAKLAND DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081282",
            "telephone_number": "269-337-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMBORN",
        "first_name": "MICHAEL",
        "middle_name": "MERLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5151015030",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101027136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.