Individual provider Active NPI

Robert K Kreitsch, MD

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
National Provider Identifier
1609882661
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
RK037552 Issued in MI
Practice address
235 Wealthy SE
Suite 100
Grand Rapids, MI 49503-5724
Phone
(616) 493-9724
Fax
(616) 493-9731
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X RK037552 MI Primary

Addresses

Primary practice location

235 Wealthy SE
Suite 100
Grand Rapids, MI 49503-5724

Mailing address

235 Wealthy St SE
Suite 100
Grand Rapids, MI 49503-5247
Phone (616) 493-9724

Other identifiers 2

IdentifierTypeStateIssuer
1421535MedicaidMI
RR250010074OtherMIMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RK037552MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Free Bed Rehabilitation Hospital Physical Medicine & Rehabilitation Past Accepting new patients
Rehabilitation Medicine Associates,PLC Physical Medicine & Rehabilitation PastSince Jun 7, 2001 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1609882661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-493-9724",
            "fax_number": "616-493-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WEALTHY SE",
            "address_2": "SUITE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035724",
            "telephone_number": "616-493-9724",
            "fax_number": "616-493-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREITSCH",
        "first_name": "ROBERT",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "RK037552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1421535",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "RR250010074",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.