Individual provider Active NPI

Michael Ku

  • Family Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1497862650
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101011151 Issued in MI
Practice address
8088 Vineyard Drive
Kalamazoo, MI 49009
Phone
(269) 286-7090
Fax
(269) 286-7091
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101011151 MI Primary

Addresses

Primary practice location

8088 Vineyard Drive
Kalamazoo, MI 49009

Mailing address

5943 Stadium Dr
Suite 3
Kalamazoo, MI 49009-3016

Other practice location 1

7901 Angling Rd
Suite 4
Portage, MI 49024-0714
Phone (269) 324-8571

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

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
I20100116000339 MI Practitioner - Family Practice 2860534690 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Healthcare CurrentSince Jan 1, 1995 Accepting new patients
Ascension Medical Group Promed Family Medicine CurrentSince Jan 1, 1995 Accepting new patients

Locations

5943 Stadium Dr
Ste 3
Kalamazoo, MI 49009
Phone (269) 226-8315

7901 Angling Rd
Ste B-201
Portage, MI 49024
Phone (269) 324-8600

7901 Angling Rd
Ste 4
Portage, MI 49024
Phone (269) 324-8571

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

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1497862650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5943 STADIUM DR",
            "address_2": "SUITE 3",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8088 VINEYARD DRIVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49009",
            "telephone_number": "269-286-7090",
            "fax_number": "269-286-7091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 Angling Rd",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490240714",
            "country_code": "US",
            "telephone_number": "269-324-8571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KU",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101011151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.