Individual provider Active NPI

Joel David Stracke, D.O.

  • Surgery Physician
  • Wyoming, MI
National Provider Identifier
1558624189
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5101020028 Issued in MI
Practice address
5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone
(616) 252-7200
NPI assigned
Jun 19, 2012
Last updated
Jun 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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 5101020028 MI Primary

Addresses

Primary practice location

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Mailing address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

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
I20190830000208 MI Practitioner - General SurgeryPractitioner - Other (Physician) 1153564943 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Michigan State University College of Osteopathic Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Mary's Health ServicesGroup PAC ID 4981500436, 175 clinicians
West Michigan Surgical Specialists PLCGroup PAC ID 3870583727, 11 clinicians

Practice addresses (Care Compare)

1000 Edison Ave NW
Christian Rest Home
Grand Rapids, MI 49504-3918
Phone (616) 453-2475

1010 Edison Ave NW
Edison Assisted Living Center
Grand Rapids, MI 49504-3918
Phone (616) 453-0581

1045 Gezon Pkwy SW
Wyoming, MI 49509-9542
Phone (616) 456-5311

300 Lafayette Ave SE
Suite 3200
Grand Rapids, MI 49503-4692
Phone (616) 685-6920

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Oct 1, 2019 Accepting new patients
Saint Mary's Health Services CurrentSince Mar 24, 2024 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Saint Mary's Health Services CurrentSince Mar 24, 2024 Accepting new patients
West Michigan Surgical Specialists PLC Surgery CurrentSince Oct 1, 2019 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Oct 1, 2019 Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

300 Lafayette Ave SE
Ste 3200
Grand Rapids, MI 49503
Phone (616) 685-6920

1045 Gezon Pkwy SW
Wyoming, MI 49509
Phone (616) 456-5311

Interoperability endpoints

  • Direct secure messaging: jstracke154092@direct.trinity-health.org

Organizations & group practices 7

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

Hospital & facility affiliations 2

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": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1558624189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRACKE",
        "first_name": "JOEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101020028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.