Individual provider Active NPI

Scott Duemler, MD

  • Family Medicine Physician
  • Byron Center, MI
National Provider Identifier
1306898036
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301053690 Issued in MI
Practice address
7740 Byron Center Ave SW
Suite 202
Byron Center, MI 49315-6929
Phone
(616) 217-5100
Fax
(616) 217-5105
NPI assigned
May 17, 2006
Last updated
Aug 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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 4301053690 MI Primary

Addresses

Primary practice location

7740 Byron Center Ave SW
Suite 202
Byron Center, MI 49315-6929

Mailing address

7740 Byron Center Ave SW
Suite 202
Byron Center, MI 49315-6929
Phone (616) 217-5100

Other identifiers 5

IdentifierTypeStateIssuer
3415591MedicaidMI
4554974MedicaidMI
4877115MedicaidMI
4179022MedicaidMI
4187964MedicaidMI

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
I20040726000851 MI Practitioner - Family Practice 9537149893 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Hahnemann University College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patient One Care, PLLCGroup PAC ID 1658653860, 12 clinicians
Timothy J. Tobolic, MD, PLLCGroup PAC ID 3274720057, 2 clinicians

Practice addresses (Care Compare)

1740 28TH St SE
Grand Rapids, MI 49508-1414
Phone (616) 323-3999

7740 Byron Ctr Ave SW
Suite 202
Byron Center, MI 49315-6929
Phone (616) 217-5100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301053690MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patient One Care, PLLC Family Medicine CurrentSince Nov 13, 2019 Accepting new patients
Patient One Care PLLC CurrentSince Nov 13, 2019 Accepting new patients
Patient One Care, PLLC Current Accepting new patients
Timothy J. Tobolic, MD, PLLC Family Medicine CurrentSince Aug 20, 2019 Accepting new patients
Patient One Care PLLC Past Accepting new patients
Advantage Health Physicians PC Family Medicine Past Accepting new patients

Locations

7740 Byron Center Ave SW
Ste 202
Byron Center, MI 49315
Phone (616) 217-5100

1740 28th St SE
Grand Rapids, MI 49508
Phone (616) 200-8669

Interoperability endpoints

  • Direct secure messaging: scott.duemler@669890552135684.direct.elationemr.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1306898036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7740 BYRON CENTER AVE SW",
            "address_2": "SUITE 202",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493156929",
            "telephone_number": "616-217-5100",
            "fax_number": "616-217-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7740 BYRON CENTER AVE SW",
            "address_2": "SUITE 202",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493156929",
            "telephone_number": "616-217-5100",
            "fax_number": "616-217-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUEMLER",
        "first_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301053690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415591",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4554974",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4877115",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4179022",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4187964",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Byron Center, MI

Sources for this page

Verify at the official NPI Registry.