Individual provider Active NPI

Dennis Allen Rasbach, M.D.

  • Surgery Physician
  • Saint Joseph, MI
National Provider Identifier
1386600526
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301 047603 Issued in MI
Practice address
2990 Niles Rd
Saint Joseph, MI 49085-8607
Phone
(269) 983-3368
Fax
(269) 983-2758
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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 4301 047603 MI Primary

Addresses

Primary practice location

2990 Niles Rd
Saint Joseph, MI 49085-8607

Mailing address

2990 Niles Rd
Saint Joseph, MI 49085-8607
Phone (269) 983-3368

Other identifiers 1

IdentifierTypeStateIssuer
4170340 10MedicaidMI

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
I20101103000590 MI Practitioner - General Surgery 7214070275 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301 047603MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Feb 6, 2017 Accepting new patients
Lakeland Medical Practices CurrentSince Feb 6, 2017 Accepting new patients

Locations

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

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

2990 Niles Rd
Saint Joseph, MI 49085
Phone (269) 429-7670

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1386600526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858607",
            "telephone_number": "269-983-3368",
            "fax_number": "269-983-2758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858607",
            "telephone_number": "269-983-3368",
            "fax_number": "269-983-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASBACH",
        "first_name": "DENNIS",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301   047603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4170340   10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.