Individual provider Active NPI

Max D Rappaport, M.D.

  • Surgery Physician
  • Hastings, MI
National Provider Identifier
1366436255
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301052627 Issued in MI
Practice address
1005 W Green St
Suite 300
Hastings, MI 49058-1712
Phone
(269) 948-3632
Fax
(269) 948-9874
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301052627 MI Primary

Addresses

Primary practice location

1005 W Green St
Suite 300
Hastings, MI 49058-1712

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/
Direct Messaging Address mrappaport4644@epic00.shdirect.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
I20110906000632 MI Practitioner - General Surgery 1153327416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wayne State University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pennock HospitalGroup PAC ID 4587551015, 79 clinicians

Practice addresses (Care Compare)

1005 W Green St
Hastings, MI 49058-1725

1009 W Green St
Corewell Health Pennock Hospital
Hastings, MI 49058-1710
Phone (269) 948-3129

Hospital & facility affiliations

  • Corewell Health Pennock Hospital Hospital, Hastings, MI, CCN 231339
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy35
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pennock Hospital Surgery CurrentSince Sep 1, 2011 Accepting new patients
Pennock Hospital CurrentSince Sep 1, 2011 Accepting new patients
Pennock Hospital Current Accepting new patients
Spectrum Health Primary Care Partners Past Accepting new patients

Locations

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

1005 W Green St
Ste 300
Hastings, MI 49058
Phone (269) 948-8411

1009 W Green St
Hastings, MI 49058
Phone (269) 945-1212

1108 W State St
Ste 3
Hastings, MI 49058
Phone (269) 945-0922

Interoperability endpoints

  • Direct secure messaging: mrappaport4644@epic00.shdirect.org

Organizations & group practices 4

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 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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1366436255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W GREEN ST",
            "address_2": "SUITE 300",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490581712",
            "telephone_number": "269-948-3632",
            "fax_number": "269-948-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPPAPORT",
        "first_name": "MAX",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301052627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1005 W Green St",
            "address_2": "Suite 300",
            "city": "Hastings",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490581712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrappaport4644@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "1005 W Green St",
            "address_2": "Suite 300",
            "city": "Hastings",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490581712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hastings, MI

Sources for this page

Verify at the official NPI Registry.