Individual provider Active NPI

Stephen Colden Cahill, D.O.

  • Dermatology Physician
  • Grand Rapids, MI
National Provider Identifier
1467650325
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
5101017387 Issued in MI
Practice address
1740 E Paris Ave SE
Grand Rapids, MI 49546-6204
Phone
(616) 949-5600
Fax
(616) 949-6571
NPI assigned
Jul 3, 2007
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 5101017387 MI Primary
Family Medicine Physician 207Q00000X 5101017387 MI

Addresses

Primary practice location

1740 E Paris Ave SE
Grand Rapids, MI 49546-6204

Mailing address

1740 E Paris Ave SE
Grand Rapids, MI 49546-6204
Phone (616) 949-5600

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
I20110323000611 MI Practitioner - DermatologyPractitioner - Family Practice 9830372184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dawm, PLCGroup PAC ID 8224032594, 18 clinicians

Practice addresses (Care Compare)

1740 E Paris Ave SE
Grand Rapids, MI 49546-6204
Phone 61657568941194

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision93
Removal of skin lesions681
Removal or shaving of skin growth1-10
Skin biopsy271

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dawm, PLC Dermatology CurrentSince Jul 1, 2018 Accepting new patients
Internal Medicine and Pediatrics of West Michigan PastSince Jun 18, 2021 Accepting new patients
Lansing Urgent Care, PLC PastSince Feb 22, 2015 Accepting new patients

Locations

1740 East Paris Ave SE
Grand Rapids, MI 49546
Phone (616) 575-6894

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

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 3

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1467650325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466204",
            "telephone_number": "616-949-5600",
            "fax_number": "616-949-6571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466204",
            "telephone_number": "616-949-5600",
            "fax_number": "616-949-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAHILL",
        "first_name": "STEPHEN",
        "middle_name": "COLDEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5101017387",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101017387",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.