NPIMap

Individual provider Active NPI

Todd Alan Hart, MD

  • Anesthesiology Physician
  • Grand Rapids, MI
National Provider Identifier
1649242223
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301082945 Issued in MI
Practice address
3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756
Phone
(616) 364-4200
Fax
(616) 364-7347
NPI assigned
Feb 7, 2006
Last updated
Jul 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301082945 MI Primary

Addresses

Primary practice location

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756

Mailing address

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756
Phone (616) 364-4200

Other identifiers 1

IdentifierTypeStateIssuer
4591207MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040609001133 MI Practitioner - Anesthesiology 5294718425 Reassigns benefits to 2 organizations
I20260130000008 WI Practitioner - Anesthesiology 5294718425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Wisconsin School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Association of Hospital Anesthesiologists SCGroup PAC ID 3476539875, 84 clinicians
West Michigan Anesthesia PCGroup PAC ID 1355243551, 69 clinicians

Practice addresses (Care Compare)

130 2ND St
Neenah, WI 54956-2883
Phone (920) 729-3100

80 68TH St SE
Spectrum Health South Pavilion
Grand Rapids, MI 49548-6980
Phone (616) 391-8220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301082945MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Consultants, PC Anesthesiology CurrentSince Oct 1, 2011 Accepting new patients
West Michigan Anesthesia, PC Anesthesiology CurrentSince May 3, 2004 Accepting new patients
Association of Hospital Anesthesiologists SC Anesthesiology CurrentSince Feb 1, 2026 Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

3333 Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 284-3132

4055 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 252-4410

80 68th St SE
Kentwood, MI 49548
Phone (616) 391-8220

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

736 Ford St
Kimberly, WI 54136

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

130 2nd St
#A107
Neenah, WI 54956

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404345600000",
    "number": "1649242223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259756",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259756",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "TODD",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2014-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301082945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4591207",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.