NPIMap

Individual provider Active NPI

Michael App, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1467490953
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301071009 Issued in MI
Practice address
655 Kenmoor Ave SE Ste 200
Grand Rapids, MI 49546-8622
Phone
(616) 363-7690
Fax
(616) 942-8917
NPI assigned
Jun 4, 2006
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301071009 MI Primary

Addresses

Primary practice location

655 Kenmoor Ave SE Ste 200
Grand Rapids, MI 49546-8622

Mailing address

655 Kenmoor Ave SE Ste 200
Grand Rapids, MI 49546-8622
Phone (616) 363-7690

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
I20040126000354 MI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6002718400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Wayne State University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine and Pediatrics of West Michigan LLCGroup PAC ID 6305090507, 8 clinicians

Practice addresses (Care Compare)

655 Kenmoor Ave SE
Suite 200
Grand Rapids, MI 49546-8622
Phone (616) 363-7690

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301071009MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine and Pediatrics of West Michigan Internal Medicine CurrentSince Dec 3, 2012 Accepting new patients
Dawm, PLC CurrentSince May 16, 2022 Accepting new patients
Internal Medicine and Pediatrics of West Michigan, LLC Internal Medicine Past Accepting new patients

Locations

1787 Grand Ridge Ct NE
Ste 103
Grand Rapids, MI 49525
Phone (616) 363-7690

655 Kenmoor Ave SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 363-7690

Interoperability endpoints

  • Direct secure messaging: mapp316@epic00.corewelldirect.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ventura TrustGrand Rapids, MI, CCN 231661 Hospice Contracted Managing Employee Jul 24, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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 5

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1467490953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 KENMOOR AVE SE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468622",
            "telephone_number": "616-363-7690",
            "fax_number": "616-942-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 KENMOOR AVE SE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468622",
            "telephone_number": "616-363-7690",
            "fax_number": "616-942-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APP",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301071009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.