Individual provider Active NPI

Kathy Rosema, DO

  • Family Medicine Physician
  • Shelby, MI
National Provider Identifier
1689628927
Registry record updated May 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101009504 Issued in MI
Practice address
119 S State St
Shelby, MI 49455-1243
Phone
(231) 861-2130
Fax
(231) 861-4964
NPI assigned
May 20, 2006
Last updated
May 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101009504 MI Primary

Addresses

Primary practice location

119 S State St
Shelby, MI 49455-1243

Mailing address

2201 S Getty Street
Muskegon, MI 49444-1207
Phone (231) 739-9315

Other identifiers 1

IdentifierTypeStateIssuer
4267920MedicaidMI

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
I20031208000460 MI Practitioner - Family PracticePractitioner - General Practice 1052217593 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MGH Family Health CenterGroup PAC ID 2860384831, 24 clinicians

Practice addresses (Care Compare)

2201 S Getty St
Muskegon, MI 49444-1207
Phone (231) 739-9315

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Resources of West Michigan CurrentSince Aug 1, 2023 Accepting new patients
Senior Resources of West Michigan CurrentSince Aug 1, 2023 Accepting new patients
Patricia Roy D.O. PC Family Medicine PastSince Jan 18, 1990 Accepting new patients
MGH Family Health Center Family Medicine Past Accepting new patients
HPCN Family Medicine Past Accepting new patients

Locations

560 Seminole Rd
Norton Shores, MI 49444
Phone (231) 733-8686

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20787/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/GGGFDD
  • Direct secure messaging: kathyrosema@mfc.allscriptsdirect.net
  • Direct secure messaging: krosema2011888@direct.trinity-health.org

Organizations & group practices 6

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 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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495152000000",
    "number": "1689628927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 S GETTY STREET",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441207",
            "telephone_number": "231-739-9315",
            "fax_number": "231-737-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S STATE ST",
            "city": "SHELBY",
            "state": "MI",
            "postal_code": "494551243",
            "telephone_number": "231-861-2130",
            "fax_number": "231-861-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEMA",
        "first_name": "KATHY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2017-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101009504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4267920",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, MI

Sources for this page

Verify at the official NPI Registry.