Individual provider Active NPI

Andrew Christian Stevens, MD

  • General Practice Physician
  • Marquette, MI
National Provider Identifier
1508078098
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4301084023 Issued in MI
Practice address
580 W College Avenue
Marquette, MI 49855
Phone
(906) 225-7414
Fax
(906) 225-3031
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301084023 MI
General Practice Physician 208D00000X 4301084023 MI Primary

Addresses

Primary practice location

580 W College Avenue
Marquette, MI 49855

Mailing address

4602 Dept
Carol Stream, IL 60122-0021
Phone (906) 225-4821

Other identifiers 3

IdentifierTypeStateIssuer
5192136MedicaidMI
AS084023OtherMIBCBS OF MICHIGAN
P00423091OtherMIRAILROAD MEDICARE

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
I20070806000482 MI Practitioner - Emergency Medicine 1850482852 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wayne State University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DLP Marquette Physician Practices IncGroup PAC ID 9931359601, 193 clinicians

Practice addresses (Care Compare)

420 W Magnetic St
Marquette General Emergency Medicin
Marquette, MI 49855-2700
Phone (906) 225-3466

Hospital & facility affiliations

  • Uphs Marquette DLP Hospital Hospital, Marquette, MI, CCN 230054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301084023MIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baraga County Memorial Hospital Current Accepting new patients
Baraga County Memorial Hospital Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
Baraga County Memorial Hospital Current Accepting new patients
Baraga County Memorial Hospital CurrentSince Jul 1, 2017 Accepting new patients
Acquisition Bell Hospital LLC CurrentSince Apr 1, 2019 Accepting new patients
Acquisition Bell Hospital LLC CurrentSince Apr 1, 2019 Accepting new patients
Acquisition Bell Hospital LLC Emergency Medicine Past Accepting new patients

Locations

901 Lakeshore Dr
Ishpeming, MI 49849
Phone (906) 485-2653

18341 US Highway 41
Lanse, MI 49946
Phone (906) 524-3300

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

420 W Magnetic St
Marquette, MI 49855
Phone (906) 225-3540

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240876800000",
    "number": "1508078098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 DEPT",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601220021",
            "telephone_number": "906-225-4821",
            "fax_number": "906-225-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W COLLEGE AVENUE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-7414",
            "fax_number": "906-225-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "ANDREW",
        "middle_name": "CHRISTIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2009-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301084023",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301084023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5192136",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "AS084023",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00423091",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.