Individual provider Active NPI

Brian J Dykstra, MD

  • Pulmonary Disease Physician
  • Saint Joseph, MI
National Provider Identifier
1346225752
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
4301058528 Issued in MI
Practice address
1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone
(269) 985-4632
NPI assigned
Dec 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 4301058528 MI Primary

Addresses

Primary practice location

1234 Napier Ave
Saint Joseph, MI 49085-2112

Mailing address

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 985-4632

Other practice location 1

601 John St Ste M-510
Kalamazoo, MI 49007-5341
Phone (269) 341-7762

Other practice location 2

451 Health Pkwy
Suite C
Paw Paw, MI 49079
Phone (269) 655-1700

Other identifiers 3

IdentifierTypeStateIssuer
1346225752MedicaidMI
CA4396OtherMIRAILROAD
4517335MedicaidMI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group
Other URL SHLMedicalStaffOffice@spectrumhealth.org

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
I20040420001281 MI Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 7113913807 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
University of New Mexico School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 983-8300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Dec 28, 2020 Accepting new patients
Patholgy Services of Kalamazoo, PC Current Accepting new patients
Lakeland Medical Practices CurrentSince Dec 28, 2020 Accepting new patients
Bronson Methodist Hospital Pulmonary Disease CurrentSince Jan 1, 2008 Accepting new patients
Bronson Battle Creek Hospital CurrentSince Sep 16, 2020 Accepting new patients
Bronson Battle Creek Hospital Pulmonary Disease CurrentSince Sep 16, 2020 Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

300 North Ave
Battle Creek, MI 49017
Phone (269) 966-8000

601 John St
#M510
Kalamazoo, MI 49007
Phone (269) 341-7762

601 John St
Ste M-424
Kalamazoo, MI 49007
Phone (269) 349-3350

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
Ste M510
Kalamazoo, MI 49007
Phone (269) 341-7762

31 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 428-2417

451 Health Pkwy
Ste C
Paw Paw, MI 49079
Phone (269) 388-5864

404 Hazen St
Ste 101
Paw Paw, MI 49079
Phone (269) 657-2550

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

451 Health Pkwy
#C
Paw Paw, MI 49079
Phone (269) 655-1700

2600 W Centre Ave
Portage, MI 49024
Phone (269) 324-4141

291 W Centre Ave
Portage, MI 49024
Phone (269) 488-8430

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1346225752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-985-4632",
            "fax_number": "269-985-4523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-985-4632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 John St Ste M-510",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490075341",
            "country_code": "US",
            "telephone_number": "269-341-7762",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "451 Health Pkwy",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Paw Paw",
            "state": "MI",
            "postal_code": "49079",
            "country_code": "US",
            "telephone_number": "269-655-1700",
            "fax_number": "269-655-0765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "BRIAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301058528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346225752",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "CA4396",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4517335",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "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"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SHLMedicalStaffOffice@spectrumhealth.org",
            "affiliation": "N",
            "endpointDescription": "Lakeland Medical Practices",
            "address_1": "1234 Napier Ave",
            "city": "Saint Joseph",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490852112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.