NPIMap

Organization Active NPI

Paragon Health, PC

Doing business as Advanced Vascular Surgery

  • Vascular Surgery Physician
  • Kalamazoo, MI
National Provider Identifier
1487619136
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
PARAGON HEALTH, PC
Doing business as
Advanced Vascular Surgery
Practice address
1815 Henson Ave
Kalamazoo, MI 49048-1510
Phone
(269) 492-6507
Fax
(269) 492-6461
NPI assigned
Apr 18, 2006
Last updated
Jan 12, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PARAGON HEALTH PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Dr. Mark C. Rummel, MDNPI 1285698134
Title
President
Phone
(269) 492-6500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1815 Henson Ave
Kalamazoo, MI 49048-1510

Mailing address

1815 Henson Ave
Kalamazoo, MI 49048-1510
Phone (269) 492-6507

Other names 1

  • Advanced Vascular Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000099 MI Part B Supplier - Clinic/Group Practice 1658283007 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Three Rivers, MI; Allegan, MI; Sturgis, MI; Kalamazoo, MI; Battle Creek, MI

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Nephrology Center

Locations

360 E Chicago St
Ste 103
Coldwater, MI 49036
Phone (517) 278-2970

1815 Henson Ave
Kalamazoo, MI 49048
Phone (269) 492-6502

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1487619136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 HENSON AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481510",
            "telephone_number": "269-492-6507",
            "fax_number": "269-492-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 HENSON AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481510",
            "telephone_number": "269-492-6507",
            "fax_number": "269-492-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAGON HEALTH, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARAGON HEALTH PC",
        "enumeration_date": "2006-04-18",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "RUMMEL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-492-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Vascular Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Vascular Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.