Individual provider Active NPI

Marti J Peters-Sparling, MD

  • Family Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1285754101
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301084217 Issued in MI
Practice address
601 John St
Suite M020
Kalamazoo, MI 49007-5341
Phone
(269) 341-8282
Fax
(269) 341-8258
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301084217 MI Primary

Addresses

Primary practice location

601 John St
Suite M020
Kalamazoo, MI 49007-5341

Mailing address

601 John St
Suite M 020
Kalamazoo, MI 49007-5341
Phone (269) 341-8282

Other identifiers 4

IdentifierTypeStateIssuer
5178709MedicaidMI
5178880MedicaidMI
080C910950OtherMIBCBSM
1285754101MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

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
I20070712000609 MI Practitioner - Family Practice 2163522632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

7901 Angling Rd
Portage, MI 49024-0714
Phone (269) 324-8600

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

  • Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Promed Family Medicine CurrentSince Sep 21, 2023 Accepting new patients
Promed Healthcare CurrentSince Sep 21, 2023 Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Past Accepting new patients
Western Michigan University School of Medicine Past Accepting new patients

Locations

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

1241 W Broadway St
Three Rivers, MI 49093
Phone (269) 273-9539

Interoperability endpoints

  • Direct secure messaging: marti.peterssparling@295853262569476.direct.elationemr.com

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.

Hospital & facility affiliations 2

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1285754101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE M 020",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-8282",
            "fax_number": "269-341-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE M020",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-8282",
            "fax_number": "269-341-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS-SPARLING",
        "first_name": "MARTI",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301084217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5178709",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5178880",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "080C910950",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285754101",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.