Individual provider Active NPI

Tomasz Rafal Stankiewicz, D.O.

  • Family Medicine Physician
  • Grandville, MI
National Provider Identifier
1346654944
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101021334 Issued in MI
Practice address
3380 44TH St SW
Grandville, MI 49418-2461
Phone
(616) 685-8250
Fax
(616) 532-3564
NPI assigned
Jun 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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 5101021334 MI Primary

Addresses

Primary practice location

3380 44TH St SW
Grandville, MI 49418-2461

Mailing address

1900 44TH St SE
Kentwood, MI 49508-5008

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tstankiewicz253043@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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
I20160818000499 MI Practitioner - Family Practice 0345546925 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians
McLaren Greater LansingGroup PAC ID 7214833466, 96 clinicians

Practice addresses (Care Compare)

12805 Escanaba Dr
Suite 1
Dewitt, MI 48820-8628
Phone (517) 913-3930

5525 S Martin Luther King Jr Blvd
McLaren Urgent Care
Lansing, MI 48911-3546
Phone (517) 394-3175

Hospital & facility affiliations

  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167
  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary'S Medical Group CurrentSince Aug 28, 2017 Accepting new patients
McLaren Medical Group Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
McLaren Medical Group CurrentSince Jul 1, 2024 Accepting new patients
Henry Ford Macomb Hospital Corporation Family Medicine CurrentSince Dec 28, 2019 Accepting new patients
Advantage Health/Saint Mary'S Medical Group CurrentSince Aug 28, 2017 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Dec 28, 2019 Accepting new patients
McLaren Greater Lansing Family Medicine CurrentSince Dec 1, 2021 Accepting new patients
Mid-Michigan Physicians, PC Family Medicine Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

12805 Escanaba Dr
Ste 1
Dewitt, MI 48820
Phone (517) 913-3930

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

3380 44th St SW
Grandville, MI 49418
Phone (616) 685-8250

1540 Lake Lansing Rd
Ste 107
Lansing, MI 48912
Phone (517) 913-3800

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

1540 Lake Lansing Rd
Ste 202
Lansing, MI 48912
Phone (517) 913-3820

5525 S Martin Luther King Jr Blvd
Lansing, MI 48911
Phone (517) 913-3888

Interoperability endpoints

  • Direct secure messaging: tstankiewicz253043@epic00.shdirect.org

Organizations & group practices 8

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 3

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1346654944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 44TH ST SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182461",
            "telephone_number": "616-685-8250",
            "fax_number": "616-532-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANKIEWICZ",
        "first_name": "TOMASZ",
        "middle_name": "RAFAL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101021334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tstankiewicz253043@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "3380 44th St SW",
            "city": "Grandville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494182461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3380 44th St SW",
            "city": "Grandville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494182461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.