NPIMap

Organization Active NPI

Paragon Health, P.C.

Doing business as West Michigan Plastic Surgery

  • Plastic and Reconstructive Surgery Physician
  • Portage, MI
National Provider Identifier
1629528765
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
4301069904 Issued in MI
Legal business name
PARAGON HEALTH, P.C.
Doing business as
West Michigan Plastic Surgery
Practice address
8175 Creekside Dr Ste 100
Portage, MI 49024-5370
Phone
(269) 222-1611
Fax
(269) 222-1607
NPI assigned
Oct 13, 2016
Last updated
Jan 12, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PARAGON HEALTH, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Dr. Mark C. Rummel, M.D.
Title
President
Phone
(269) 341-4554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 4301069904 MI Primary

Addresses

Primary practice location

8175 Creekside Dr Ste 100
Portage, MI 49024-5370

Mailing address

8175 Creekside Dr Ste 100
Portage, MI 49024-5370
Phone (269) 222-1611

Other names 1

  • West Michigan Plastic Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161122000529 MI Part B Supplier - Clinic/Group Practice 1658283007 Receives reassigned benefits from 3 practitioners
Practice locations: Battle Creek, MI; Portage, MI

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Paragon Health PC

Locations

8175 Creekside Dr
Ste 100
Portage, MI 49024
Phone (269) 222-1611

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1629528765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 CREEKSIDE DR STE 100",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245370",
            "telephone_number": "269-222-1611",
            "fax_number": "269-222-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 CREEKSIDE DR STE 100",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245370",
            "telephone_number": "269-222-1611",
            "fax_number": "269-222-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAGON HEALTH, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARAGON HEALTH, P.C.",
        "enumeration_date": "2016-10-13",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "RUMMEL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-341-4554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MI",
            "license": "4301069904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Michigan Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Michigan Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.