Kevin Jon Piebenga, D.P.M., P.C.

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

001527 Issued in MI

Practice address

3330 Central Blvd
Hudsonville, MI 49426-1441

Phone

(616) 669-7525

Fax

(616) 669-9952

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kevin J. Piebenga D.P.M. P.C.

  • Foot Surgery Podiatrist
  • Hudsonville, MI
  • NPI 1215293550

  Foot Surgery, MI

  Medicare reassignment NPD Authorized official
• West Michigan Heart

  • Cardiovascular Disease Physician
  • Hudsonville, MI
  • NPI 1134560360
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1629034178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 CENTRAL BLVD",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261441",
            "telephone_number": "616-669-7525",
            "fax_number": "616-669-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 CENTRAL BLVD",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261441",
            "telephone_number": "616-669-7525",
            "fax_number": "616-669-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEBENGA",
        "first_name": "KEVIN",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.P.M., P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MI",
            "license": "001527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2693413",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rose Patterson, COTA-L
• Leah Ballantyne Peirce, MD
• Billy J Perez, LMSW
• Haley Christine Perry, LMSW
• Phases Counseling and Wellness LLC
• Platinum Living LLC
• Kati Marie Pohl, MSOTRL
• Susan Elizabeth Portfleet
• Sara Potapa
• Traci L Potter

• All providers in Hudsonville, MI
• Foot Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.