Joseph Gordon Edelson, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

4301114320 Issued in MI

Practice address

560 W Mitchell St Ste M40
Petoskey, MI 49770-2278

Phone

(231) 487-3637

Fax

(231) 487-6513

NPI assigned

Aug 3, 2005

Last updated

Nov 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO, NM2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

90.97 of 100Reported as group

Quality

79.73

Promoting interoperability

100

Improvement activities

40

Cost

78.87

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• San Juan Regional Medical Center Inc

  dba SJHP Gastroenterology

  • Gastroenterology Physician
  • Farmington, NM
  • NPI 1639662901
  Medicare reassignment NPD
• Valley View Hospital Association

  dba The Spine Center at Valley View

  • Neurological Surgery Physician
  • Aspen, CO
  • NPI 1376134841
  Medicare reassignment
• San Juan Regional Medical Center Inc

  dba SJHP Family Medicine Farmington

  • Family Medicine Physician
  • Farmington, NM
  • NPI 1710589015
  NPD
• Valley View Hospital Association

  dba The Heart and Vascular Center

  • Cardiovascular Disease Physician
  • Glenwood Springs, CO
  • NPI 1437271285
  NPD
• Valley View Hospital Association

  dba Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Carbondale, CO
  • NPI 1457235202
  NPD
• Valley View Hospital Association

  dba Women's Health

  • Obstetrics & Gynecology Physician
  • Silt, CO
  • NPI 1548805039
  NPD
• Northeast Atlanta Associates in Gastroenterology

  • Specialist
  • Tucker, GA
  • NPI 1497958409
  NPD (past)
• Northlake Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Tucker, GA
  • NPI 1871594499
  NPD (past)

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1598766255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844088",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844088",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST STE M40",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702278",
            "telephone_number": "231-487-3637",
            "fax_number": "231-487-6513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 Lakeview Ave",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810043508",
            "country_code": "US",
            "telephone_number": "719-557-3660",
            "fax_number": "719-564-2624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "630 W Maple St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874016113",
            "country_code": "US",
            "telephone_number": "505-609-6349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDELSON",
        "first_name": "JOSEPH",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "51996",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "29735",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NM",
            "license": "MD2018-0675",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301114320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598766255",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297351",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Kenneth Dziak, ABOC/NCLEC
• Jonathan Dzingle, D.D.S
• Donald Scott Eaton, D.D.S.
• Dawn Ebersole, FNP-BC
• Ecs Northern Michigan PC
• Lance Edgerton, FNP-C
• Bruce D Edwards, DDS
• James Francis Ehrnst, D.C.
• Elevate Medical Spa LLC (Elevate Medical Aesthetics and Wellness)
• Elite Movement Chiropractic Clinic PLC

• Gastroenterology Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.