Individual provider Active NPI

Boyd Evan Kroeze, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Holland, MI
National Provider Identifier
1619912540
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
4301075520 Issued in MI
Practice address
602 Michigan Ave
Holland, MI 49423-4918
Phone
(616) 394-3522
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 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 4301075520 MI Primary

Addresses

Primary practice location

602 Michigan Ave
Holland, MI 49423-4918

Mailing address

PO Box 30516
Dept 4006
Lansing, MI 48909-8016
Phone (616) 975-1845

Other identifiers 1

IdentifierTypeStateIssuer
930117094OtherMIRAILROAD MEDICARE

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
I20070604000062 MI Practitioner - Emergency Medicine 7911005772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wayne State University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epi PCGroup PAC ID 0941293302, 16 clinicians

Practice addresses (Care Compare)

602 Michigan Ave
Holland, MI 49423-4918
Phone (616) 392-5141

Hospital & facility affiliations

  • Holland Hospital Hospital, Holland, MI, CCN 230072

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital CurrentSince Nov 1, 2020 Accepting new patients
Holland Community Hospital Current Accepting new patients
Epi PC CurrentSince Jan 1, 2002 Accepting new patients
Holland Community Hospital CurrentSince Nov 1, 2020 Accepting new patients

Locations

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

3232 N Wellness Dr
Holland, MI 49424
Phone (616) 494-4250

Organizations & group practices 4

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274745600000",
    "number": "1619912540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "address_2": "DEPT 4006",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489098016",
            "telephone_number": "616-975-1845",
            "fax_number": "616-975-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234918",
            "telephone_number": "616-394-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROEZE",
        "first_name": "BOYD",
        "middle_name": "EVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2010-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301075520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930117094",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.