Individual provider Active NPI

Adam J Geller, PAC

  • Physician Assistant
  • Muskegon, MI
National Provider Identifier
1285633172
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003015 Issued in MI
Practice address
1400 Mercy Dr Ste 100
Muskegon, MI 49444-1833
Phone
(231) 830-2748
Fax
(231) 733-5212
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5601003015 MI
Physician Assistant 363A00000X 5601003015 MI Primary

Addresses

Primary practice location

1400 Mercy Dr Ste 100
Muskegon, MI 49444-1833

Mailing address

1400 Mercy Dr Ste 100
Muskegon, MI 49444-1833
Phone (231) 733-1326

Other practice location 1

1300 Michigan St NE Ste 200
Grand Rapids, MI 49503-2029
Phone (616) 774-9515

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
I20040304000616 MI Practitioner - Physician Assistant 0446147219 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Choice Urgent Care PCGroup PAC ID 9739221912, 45 clinicians

Practice addresses (Care Compare)

12841 Ford Rd
Dearborn, MI 48126-3349
Phone (313) 710-4205

23455 Michigan Ave
Dearborn, MI 48124-1908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601003015MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Mar 2, 2015 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Mar 2, 2015 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince Apr 1, 2020 Accepting new patients
Sport and Injury Clinics Current Accepting new patients
Mi Street Orthopedic Specialists PC Past Accepting new patients
Gossage Eye Institute, PLC PastSince Jan 1, 2003 Accepting new patients
Great Lakes Plastic Reconstructive & Hand Surgery P C Past Accepting new patients
First Choice Medical Group PLLC Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

15100 Whittaker Way
Grand Haven, MI 49417
Phone (616) 935-6200

1300 Michigan St NE
Ste 200
Grand Rapids, MI 49503
Phone (616) 774-9515

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

716 N Clippert St
Lansing, MI 48912
Phone (517) 253-4000

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

Interoperability endpoints

  • Direct secure messaging: adam.geller.1@20203.direct.athenahealth.com
  • Direct secure messaging: adam.geller.1@29636.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20203/brand/1/csg/1/fhir/r4

Organizations & group practices 12

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1285633172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MERCY DR STE 100",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441833",
            "telephone_number": "231-733-1326",
            "fax_number": "231-733-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MERCY DR STE 100",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441833",
            "telephone_number": "231-830-2748",
            "fax_number": "231-733-5212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Michigan St NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032029",
            "country_code": "US",
            "telephone_number": "616-774-9515",
            "fax_number": "616-774-7116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GELLER",
        "first_name": "ADAM",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601003015",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.