NPIMap

Organization Active NPI

Michigan Pain Consultants PC

  • Pain Medicine (Anesthesiology) Physician
  • Grand Rapids, MI
National Provider Identifier
1467418574
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
MICHIGAN PAIN CONSULTANTS PC
Practice address
2060 East Paris Ave SE
Suite 200
Grand Rapids, MI 49546
Phone
(616) 285-1377
Fax
(616) 285-1006
NPI assigned
Apr 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Authorized official

Name
Dr. Mark Louis Gostine, MD
Title
President
Phone
(616) 285-1377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

2060 East Paris Ave SE
Suite 200
Grand Rapids, MI 49546

Mailing address

5555 Glenwood Hills Pkwy SE Ste 2
Grand Rapids, MI 49512-2091
Phone (616) 940-2662

Other identifiers 1

IdentifierTypeStateIssuer
700D160000OtherMIBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

15044 220th Ave
Ste 100
Big Rapids, MI 49307

61 Commerce Ave SW
#3573
Grand Rapids, MI 49503

210 Court St
Ste C
Mt Pleasant, MI 48858
Phone (517) 772-1609

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJDADD

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1467418574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 GLENWOOD HILLS PKWY SE STE 2",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122091",
            "telephone_number": "616-940-2662",
            "fax_number": "616-940-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 EAST PARIS AVE SE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-285-1377",
            "fax_number": "616-285-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN PAIN CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "GOSTINE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-285-1377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "700D160000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.