Individual provider Active NPI

Paul Henri Belanger, D.O.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Norton Shores, MI
National Provider Identifier
1598980773
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
5101015391 Issued in MI
Practice address
1450 Farr Rd Ste 5000
Norton Shores, MI 49444-7789
Phone
(231) 777-2625
Fax
(231) 773-8560
NPI assigned
Apr 14, 2007
Last updated
Jul 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy Physician 207YX0602X PB015391 MI
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 5101015391 MI Primary

Addresses

Primary practice location

1450 Farr Rd Ste 5000
Norton Shores, MI 49444-7789

Mailing address

268 W Seminole Rd
Muskegon, MI 49444
Phone (231) 777-2625

Other identifiers 3

IdentifierTypeStateIssuer
040E061920OtherMIBLUE SHIELD GROUP
5195675MedicaidMI
0457410884OtherMIBLUE SHIELD PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wsenta@allmedsccd.com Direct

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
I20070726000256 MI Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 9931200599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
R Franklin University of Med & Sci/Chicago Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Shore Otolaryngology PCGroup PAC ID 4284998154, 8 clinicians

Practice addresses (Care Compare)

230 W Oak St
Fremont, MI 49412-1526
Phone (231) 777-2625

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PB015391MIMDOtolaryngic Allergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Shore Otolaryngology PC Current Accepting new patients
West Shore Otolaryngology PC CurrentSince May 1, 2018 Accepting new patients

Locations

230 W Oak St
Fremont, MI 49412
Phone (231) 924-1305

1600 S Beacon Blvd
Ste 140
Grand Haven, MI 49417
Phone 2317772625 ext. 233

1450 Farr Rd
Norton Shores, MI 49444
Phone (231) 739-7606

1450 Farr Rd
Ste 5000
Norton Shores, MI 49444
Phone (231) 739-9095

268 Seminole Rd
Norton Shores, MI 49444
Phone (231) 739-4554

Organizations & group practices 3

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 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": "1176508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1598980773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 W SEMINOLE RD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "49444",
            "telephone_number": "231-777-2625",
            "fax_number": "231-773-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 FARR RD STE 5000",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494447789",
            "telephone_number": "231-777-2625",
            "fax_number": "231-773-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELANGER",
        "first_name": "PAUL",
        "middle_name": "HENRI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-14",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "MI",
            "license": "PB015391",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MI",
            "license": "5101015391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP",
            "identifier": "040E061920",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5195675",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PIN",
            "identifier": "0457410884",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wsenta@allmedsccd.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1450 Farr Rd Ste 5000",
            "city": "Norton Shores",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494447789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Norton Shores, MI

Sources for this page

Verify at the official NPI Registry.