NPIMap

Individual provider Active NPI

Benjamin Schaefer, PA

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1356444335
Registry record updated Mar 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002449 Issued in MI
Practice address
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone
(616) 459-6867
Fax
(616) 459-6963
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601002449 MI Primary

Addresses

Primary practice location

100 Michigan St NE
Grand Rapids, MI 49503-2560

Mailing address

PO Box 1682
Grand Rapids, MI 49501-1682
Phone (616) 774-5221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040224000038 MI Practitioner - Physician Assistant 9133015514 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willis F Gaffney MD PCGroup PAC ID 1658526462, 4 clinicians

Practice addresses (Care Compare)

2939 S Sheridan Rd
Stanton, MI 48888-9285
Phone (989) 831-9009

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Willis F Gaffney M.D. P.C. CurrentSince Aug 1, 2022 Accepting new patients
Advantage Health Saint Mary's Medical Group Physician Assistant CurrentSince Nov 8, 2018 Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince Nov 8, 2018 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Dec 12, 2022 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Hospitalists of West Michigan PC Past Accepting new patients
Lansing Urgent Care, PLC Past Accepting new patients
Access Medical Management, Inc. Past Accepting new patients
Spectrum Health Hospitals Past Accepting new patients
Grand Rapids Addiction Medicine Specialists PC Past Accepting new patients

Locations

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

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

3550 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-2530

2939 S Sheridan Rd
Stanton, MI 48888
Phone (989) 831-9009

Organizations & group practices 12

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 2

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1356444335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1682",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495011682",
            "telephone_number": "616-774-5221",
            "fax_number": "616-774-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-459-6867",
            "fax_number": "616-459-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "BENJAMIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.