Active NPI
Robert J Eastway, DO
- Cardiovascular Disease Physician
- Muskegon, MI
National Provider Identifier
1306844055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 5101020800
- Practice address
- 1212 E Sherman Blvd
Muskegon, MI 49444-1879 - Phone
- (231) 672-3500
- Fax
- (231) 672-6199
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Cardiology Physician | 207RI0011X | 3400-2367 | OH | |
| Cardiovascular Disease Physician | 207RC0000X | 5101020800 | MI | Primary |
Addresses
Primary practice location
1212 E Sherman Blvd
Muskegon, MI 49444-1879
Mailing address
55 Arthur St
Manistee, MI 49660-1101
Phone (231) 727-4444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0278686 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2367 | OH | MD | Chiropractor |
| 3400-2367 | OH | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Mercy Health Physicians Lima, LLC | Interventional Cardiology | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Family Medicine Physician
- Lima, OH
- NPI 1225292865
Interventional Cardiology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1306844055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 ARTHUR ST",
"city": "MANISTEE",
"state": "MI",
"postal_code": "496601101",
"telephone_number": "231-727-4444",
"fax_number": "231-728-4789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 E SHERMAN BLVD",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494441879",
"telephone_number": "231-672-3500",
"fax_number": "231-672-6199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EASTWAY",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "OH",
"license": "3400-2367",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MI",
"license": "5101020800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0278686",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.