Randall Scott Kuntzman, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

4301073862 Issued in MI

Practice address

4070 Lake Dr SE
Grand Rapids, MI 49546-8294

Phone

(616) 949-4340

Fax

(616) 949-4341

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Urology

Education

Wayne State University School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urology Surgeons PCGroup PAC ID 3072559863, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
• Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
• Spectrum Health United Hospital Hospital, Greenville, MI, CCN 230035

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkuntzman3356@epic00.corewelldirect.org

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.

• Urology Surgeons PC

  • Urology Physician
  • Grand Rapids, MI
  • NPI 1467561480
  Medicare reassignment Care Compare group NPD
• Advantage Health/Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment NPD
• Advantage Health Saint Mary'S Medical Group

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health/Saint Mary'S Medical Group

  • Clinic/Center
  • Sparta, MI
  • NPI 1760599906
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Saint Mary'S Health Services

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation
• Spectrum Health United

  • General Acute Care Hospital
  • Greenville, MI
  • NPI 1457304495
  Care Compare affiliation

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558471284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 LAKE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468294",
            "telephone_number": "616-949-4340",
            "fax_number": "616-949-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 LAKE DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468294",
            "telephone_number": "616-949-4340",
            "fax_number": "616-949-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNTZMAN",
        "first_name": "RANDALL",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301073862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4103900",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Kunkel
• Bryan Kunkler, MD
• Katherine E. Kunnen, DNP, FNP-C, PMHNP-BC
• Kody S Kunnen, PA-C
• Philip Kunnen
• Kimberley A Kunze, PSY.D.
• Michael Kuo, MD
• Sherry Kuo, DO
• Audra Lou Kuperus, COTAL
• Joshua Mark Kuperus

• Urology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.