Individual provider Active NPI

Mary P. Wilkins, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Kalamazoo, MI
National Provider Identifier
1578591483
Registry record updated Mar 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
4301406878 Issued in MI
Practice address
125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832
Phone
(269) 343-3900
Fax
(269) 343-5640
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 4301406878 MI Primary

Addresses

Primary practice location

125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832

Mailing address

125 S Kalamazoo Mall
Suite 204
Kalamazoo, MI 49007-4832
Phone (269) 343-3900

Other identifiers 2

IdentifierTypeStateIssuer
10/2736824MedicaidMI
104687077MedicaidMI

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
I20050115000125 MI Practitioner - Emergency Medicine 6103875232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Nebraska College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwestern Michigan Emergency Services, PCGroup PAC ID 1456265891, 69 clinicians

Practice addresses (Care Compare)

408 Hazen St
Paw Paw, MI 49079-1019
Phone (269) 657-3141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.26 of 100Reported as group
Quality
79.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Michigan Emergency Services, PC Emergency Medical Services CurrentSince Aug 1, 1998 Accepting new patients
Bronson Methodist Hospital Past Accepting new patients

Locations

555 Linn St
Allegan, MI 49010
Phone (269) 673-8424

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

125 S Kalamazoo Mall
Ste 204
Kalamazoo, MI 49007
Phone (269) 343-3900

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

955 S Bailey Ave
South Haven, MI 49090
Phone (269) 637-5271

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 3

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1578591483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL",
            "address_2": "SUITE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074832",
            "telephone_number": "269-343-3900",
            "fax_number": "269-343-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL",
            "address_2": "SUITE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074832",
            "telephone_number": "269-343-3900",
            "fax_number": "269-343-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "MARY",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301406878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10/2736824",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104687077",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.