Organization Active NPI

Mercy Specialty Services

Doing business as Trinity Health Medical Group

  • Internal Medicine Physician
  • Muskegon, MI
National Provider Identifier
1629010384
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MERCY SPECIALTY SERVICES
Doing business as
Trinity Health Medical Group
Practice address
1150 E Sherman Blvd Ste 2400
Muskegon, MI 49444
Phone
(231) 672-6336
Fax
(231) 672-6335
NPI assigned
Jun 10, 2006
Last updated
Mar 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HEALTH PARTNERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Michael Gusho
Title
Chief Financial Officer
Phone
(734) 398-0642

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204D00000X MI
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MI Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X MI
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X MI
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X MI
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1150 E Sherman Blvd Ste 2400
Muskegon, MI 49444

Mailing address

PO Box 776982
Chicago, IL 60677-6982
Phone (800) 494-5797

Other practice location 1

6401 Prairie St Ste 2300
Norton Shores, MI 49444-7842
Phone (231) 727-7928

Other practice location 2

1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone (231) 672-3883

Other practice location 3

1310 Wisconsin St Ste 200
Grand Haven, MI 49417-2472
Phone (616) 844-4790

Other names 2

  • Trinity Health Medical Group Doing business as
  • Mercy General Specialty Services Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040429000064 MI Part B Supplier - Clinic/Group Practice 2365439544 Receives reassigned benefits from 96 practitioners
Practice locations: Norton Shores, MI; Shelby, MI; Muskegon, MI; Grand Haven, MI
O20040804001335 MI Part B Supplier - Clinic/Group Practice 2365439544 Receives reassigned benefits from 24 practitioners
Practice locations: Norton Shores, MI; Grand Haven, MI; Muskegon, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2163361Trinity Health Medical Group - Academic Geriatrics1150 E Sherman Blvd Ste 1175, Muskegon, MI 49444Certificate of waiverMar 12, 2027
23D2164747Trinity Health Medical Group1150 E Sherman Blvd Suite 1100, Muskegon, MI 49444Certificate of waiverApr 11, 2027

National Provider Directory

National Provider Directory
Part of
Mercy Hospital

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1310 Wisconsin St
Ste 103
Grand Haven, MI 49417
Phone (616) 846-2640

1500 E Sherman Blvd
Ste 240
Muskegon, MI 49444

1675 Leahy St
Ste 215
Muskegon, MI 49442
Phone (231) 722-1031

1675 Leahy St
Ste 304B
Muskegon, MI 49442
Phone (231) 728-1695

1675 Leahy St
Ste 404B
Muskegon, MI 49442
Phone (231) 728-1695

1675 Leahy St
Ste 428
Muskegon, MI 49442
Phone (231) 672-3300

1675 Leahy St
Ste 428B
Muskegon, MI 49442
Phone (231) 672-3300

Practitioners & affiliated clinicians

Practitioners 155

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 155

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1629010384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776982",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776982",
            "telephone_number": "800-494-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E SHERMAN BLVD STE 2400",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "49444",
            "telephone_number": "231-672-6336",
            "fax_number": "231-672-6335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6401 Prairie St Ste 2300",
            "address_purpose": "LOCATION",
            "city": "Norton Shores",
            "state": "MI",
            "postal_code": "494447842",
            "country_code": "US",
            "telephone_number": "231-727-7928",
            "fax_number": "231-727-7844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 E Sherman Blvd",
            "address_purpose": "LOCATION",
            "city": "Muskegon",
            "state": "MI",
            "postal_code": "494441849",
            "country_code": "US",
            "telephone_number": "231-672-3883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1310 Wisconsin St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Grand Haven",
            "state": "MI",
            "postal_code": "494172472",
            "country_code": "US",
            "telephone_number": "616-844-4790",
            "fax_number": "616-844-4794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MERCY SPECIALTY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH PARTNERS",
        "enumeration_date": "2006-06-10",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "GUSHO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "734-398-0642"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Trinity Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy General Specialty Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.