Individual provider Active NPI

Bruce Michael Fletter, MD

  • Surgery Physician
  • Holland, MI
National Provider Identifier
1518914779
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301079312 Issued in MI
Practice address
588 E Lakewood Blvd
Holland, MI 49424-2023
Phone
(616) 494-5830
Fax
(616) 494-5901
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301079312 MI Primary

Addresses

Primary practice location

588 E Lakewood Blvd
Holland, MI 49424-2023

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Other identifiers 2

IdentifierTypeStateIssuer
1558407189OtherGROUP NPI
1922090554OtherCORP NPI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Bruce.Fletter@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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
I20100108000071 MI Practitioner - General Surgery 1658412994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Toledo College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

588 E Lakewood Blvd FL
Holland, MI 49424-2023

602 Michigan Ave
Suite 102
Holland, MI 49423-4918
Phone (616) 494-8724

8333 Felch St
Zeeland, MI 49464-2608

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Varicose vein removal14
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2011 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2011 Accepting new patients

Locations

15100 Whittaker Way
Grand Haven, MI 49417
Phone (616) 935-6200

4085 Burton St SE
Ste 200
Grand Rapids, MI 49546

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

1300 Michigan St NE
Ste 103
Grand Rapids, MI 49503
Phone (616) 459-8338

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

221 Michigan St NE
Ste 200
Grand Rapids, MI 49503
Phone (616) 391-8635

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

588 E Lakewood Blvd
Fl 2
Holland, MI 49424
Phone (616) 494-5800

588 E Lakewood Blvd
Holland, MI 49424
Phone (616) 494-5800

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

6105 Wilson Ave SW
Wyoming, MI 49418
Phone (616) 486-5055

8333 Felch St
Ste 300
Zeeland, MI 49464
Phone (616) 267-9823

Interoperability endpoints

  • Direct secure messaging: bruce.fletter@epic00.shdirect.org
  • Direct secure messaging: bfletter7876@epic00.corewelldirect.org

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.

Hospital & facility affiliations 4

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1518914779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 E LAKEWOOD BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242023",
            "telephone_number": "616-494-5830",
            "fax_number": "616-494-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETTER",
        "first_name": "BRUCE",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301079312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1558407189",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORP NPI",
            "identifier": "1922090554",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Bruce.Fletter@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "588 E Lakewood Blvd",
            "city": "Holland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494242023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "588 E Lakewood Blvd",
            "city": "Holland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494242023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.