Nicholas Michael Bontumasi, M.D.
Individual provider Active NPI Dermatology Physician · Grand Haven, MI
NPI 1306289574 · NPPES record last updated Feb 28, 2022
Key facts
- NPI
- 1306289574
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- R-09922 (IA)
- Practice address
- 1600 S Beacon Blvd Ste 160
Grand Haven, MI 49417-2654 - Phone
- (616) 268-2001
- Fax
- (616) 268-2002
- NPI assigned
- Apr 8, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- Washington University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Forefront Dermatology SC
Practice addresses (Care Compare)
1007 Harbor Hills Dr
Suite C
Marquette, MI 49855-8977
Phone (906) 225-5458
1600 S Beacon Blvd
Suite 160
Grand Haven, MI 49417-2654
Phone (616) 268-2001
Hospital & facility affiliations
- Spectrum Health
- Trinity Health Ann Arbor Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.45 of 100
- Promoting interoperability
- 97
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 36 |
| Removal of skin lesions | 440 |
| Removal or shaving of skin growth | 14 |
| Skin biopsy | 309 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170519000074 | MI | Practitioner - Dermatology | 7416224670 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R-09922 | IA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forefront Dermatology, S.C. | Dermatology | Current |
Accepting new patients |
| Forefront Dermatology, S.C. | Dermatology | Current |
Accepting new patients |
| Floyd County Memorial Hospital Commission | Past | Accepting new patients | |
| Forefront Dermatology, S.C. | Dermatology | Past | Accepting new patients |
| Forefront Dermatology, S.C. | Dermatology | Past | Accepting new patients |
Locations
1600 S Beacon Blvd
Ste 160
Grand Haven, MI 49417
Phone (616) 268-2001
4362 Cascade Rd SE
Ste 206
Grand Rapids, MI 49546
Phone (616) 678-2070
2525 East Paris Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 678-2070
1007 Harbor Hills Dr
Ste C
Marquette, MI 49855
Phone (906) 225-5458
801 York St
Manitowoc, WI 54220
Phone (866) 630-9882
Interoperability endpoints
- nicholas.bontumasi@forefrontdermatology.emadirect.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | R-09922 | IA | Yes |
Addresses
Primary practice location
1600 S Beacon Blvd Ste 160
Grand Haven, MI 49417-2654
Mailing address
801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008
Other practice location 1
2525 E Paris Ave SE Ste 100
Grand Rapids, MI 49546-6191
Phone (616) 678-2070
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Nicholas.Bontumasi@forefrontdermatology.emadirect.md | ||
| Direct Messaging Address | Nicholas.Bontumasi@forefrontdermatology.emadirect.md |
Other providers in Grand Haven, MI
- Karen Boeve
- Norman Russell Boeve
- Keegan Bohn
- Cynthia Ann Bolling
- Shawn C Bonner
- Ashley Bookmyer
- Daniela Borecky
- Evelyn Bosman
- Daniel Anthony Bowen
- Susan Bowers
All providers in Grand Haven, MI · Dermatology 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 Feb 28, 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.
- Order and Referring (CMS).
- 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.