Individual provider Active NPI

Madison Suzanna Craze

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1467020347
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
940 John St
Kalamazoo, MI 49001-2857
Phone
(269) 343-7296
NPI assigned
Jun 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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 Primary

Addresses

Primary practice location

940 John St
Kalamazoo, MI 49001-2857

Mailing address

916 Austin St
Kalamazoo, MI 49008-1105
Phone (586) 713-9718

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929001169 MI Practitioner - Physician Assistant 2860899119 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Western Michigan Un Homer Stryker School of Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
VMD Primary Providers Eastern Michigan PCGroup PAC ID 9234480575, 63 clinicians

Practice addresses (Care Compare)

39475 Lewis Dr
Novi, MI 48377-2977

620 N Pontiac TRL
Pontiac Trail Medical Center
Walled Lake, MI 48390-3448
Phone (248) 624-4511

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Healthcare CurrentSince Nov 14, 2021 Accepting new patients
Ascension Medical Group Promed CurrentSince Nov 14, 2021 Accepting new patients

Locations

940 John St
Kalamazoo, MI 49001
Phone (269) 343-7296

1717 Shaffer St
Kalamazoo, MI 49048
Phone (269) 226-5050

1717 Shaffer St
Ste 002
Kalamazoo, MI 49048

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Interoperability endpoints

  • Direct secure messaging: madison.craze.1@21803.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1467020347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 AUSTIN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081105",
            "telephone_number": "586-713-9718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 JOHN ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490012857",
            "telephone_number": "269-343-7296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAZE",
        "first_name": "MADISON",
        "middle_name": "SUZANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.