Individual provider Active NPI

Michael Anthony Digiorgio, PA-C

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1467927376
Registry record updated Oct 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008774 Issued in MI
Practice address
2490 S 11TH St
Kalamazoo, MI 49009-2175
Phone
(269) 343-1535
NPI assigned
Oct 6, 2018
Last updated
Oct 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2018

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 5601008774 MI Primary

Addresses

Primary practice location

2490 S 11TH St
Kalamazoo, MI 49009-2175

Mailing address

22455 McPhall Rd
Armada, MI 48005-1433
Phone (586) 651-1015

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
I20181221001575 MI Practitioner - Physician Assistant 3173868908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

23829 Little Mack Ave
Saint Clair Shores, MI 48080-1186
Phone (586) 773-1300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Healthcare CurrentSince Dec 1, 2018 Accepting new patients
Beacon Medical Group Michigan Inc CurrentSince Dec 1, 2018 Accepting new patients
St Clair Orthopaedics and Sports Medicine PC CurrentSince Dec 7, 2020 Accepting new patients

Locations

2490 S 11th St
Ste 201
Kalamazoo, MI 49009
Phone (269) 343-1535

22701 Hall Rd
Ste 100
Macomb, MI 48042
Phone (586) 416-1300

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

23829 Little Mack Ave
Ste 100
St Clr Shores, MI 48080
Phone (586) 416-1300

Interoperability endpoints

  • Direct secure messaging: mdigiorgio708282@direct.hfhs.org

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 2

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": "1538784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538784000000",
    "number": "1467927376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22455 MCPHALL RD",
            "city": "ARMADA",
            "state": "MI",
            "postal_code": "480051433",
            "telephone_number": "586-651-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 S 11TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092175",
            "telephone_number": "269-343-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGIORGIO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-06",
        "last_updated": "2018-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.