Individual provider Active NPI

Aeryn Naomi Kangas-Dick, MD

  • Surgery Physician
  • Kalamazoo, MI
National Provider Identifier
1609307347
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301514752 Issued in MI
Practice address
200 N Park St
Kalamazoo, MI 49007-3731
Phone
(269) 382-2500
Fax
(269) 373-7478
NPI assigned
Mar 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2026

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 4301514752 MI Primary

Addresses

Primary practice location

200 N Park St
Kalamazoo, MI 49007-3731

Mailing address

200 N Park St
Kalamazoo, MI 49007-3731
Phone (269) 382-2500

Other practice location 1

601 John St Ste M-283A
Kalamazoo, MI 49007-5341
Phone (269) 349-7696

Other practice location 2

Elm and Carlton St
Buffalo, NY 14263-0001
Phone (716) 845-1300 ext. 2506

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

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
I20250808003945 MI Practitioner - General Surgery 0840534392 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Michigan University School of MedicineGroup PAC ID 7517113954, 76 clinicians
West Michigan Cancer CenterGroup PAC ID 8628971199, 16 clinicians
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone (269) 345-2974

200 N Park St
Kalamazoo, MI 49007-3731
Phone (269) 373-7453

601 John St
283A
Kalamazoo, MI 49007-5341
Phone (269) 349-7696

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301514752MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Cancer Center CurrentSince Aug 1, 2025 Accepting new patients
Western Michigan University School of Medicine CurrentSince Oct 16, 2025 Accepting new patients
West Michigan Cancer Center CurrentSince Aug 1, 2025 Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Past Accepting new patients

Locations

1000 Oakland Dr
Kalamazoo, MI 49008
Phone (269) 337-4347

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

200 N Park St
Kalamazoo, MI 49007
Phone (269) 373-7453

601 John St
Ste M-283
Kalamazoo, MI 49007
Phone (269) 349-7696

Organizations & group practices 5

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 1

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1609307347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073731",
            "telephone_number": "269-382-2500",
            "fax_number": "269-373-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073731",
            "telephone_number": "269-382-2500",
            "fax_number": "269-373-7478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 John St Ste M-283A",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490075341",
            "country_code": "US",
            "telephone_number": "269-349-7696",
            "fax_number": "269-488-8313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Elm and Carlton St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142630001",
            "country_code": "US",
            "telephone_number": "716-845-1300 x2506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANGAS-DICK",
        "first_name": "AERYN",
        "middle_name": "NAOMI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301514752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.