Individual provider Active NPI

Monica Lane Gary, MD

  • Obstetrics & Gynecology Physician
  • Grand Rapids, MI
National Provider Identifier
1699903716
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301094699 Issued in MI
Practice address
555 Midtowne St NE
Suite 400
Grand Rapids, MI 49503-5729
Phone
(616) 588-1200
Fax
(616) 588-1219
NPI assigned
Jun 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301094699 MI Primary

Addresses

Primary practice location

555 Midtowne St NE
Suite 400
Grand Rapids, MI 49503-5729

Mailing address

555 Midtowne St NE
Ste 400
Grand Rapids, MI 49503-5731
Phone (616) 588-1200

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
I20130911000654 MI Practitioner - Obstetrics/Gynecology 4789828815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Arizona College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Rapids Womens Health PCGroup PAC ID 8729162185, 21 clinicians

Practice addresses (Care Compare)

555 Midtown St NE
Suite 400
Grand Rapids, MI 49503-5731
Phone (616) 588-1200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301094699MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Rapids Womens Health PC Obstetrics & Gynecology CurrentSince Sep 3, 2013 Accepting new patients
Spectrum Health Hospitals Past Accepting new patients

Locations

555 Midtowne St NE
Ste 400
Grand Rapids, MI 49503
Phone (616) 588-1200

555 Midtowne St NE
Ste 450
Grand Rapids, MI 49503
Phone (616) 588-1200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516147200000",
    "number": "1699903716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE ST NE",
            "address_2": "STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035731",
            "telephone_number": "616-588-1200",
            "fax_number": "616-588-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE ST NE",
            "address_2": "SUITE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035729",
            "telephone_number": "616-588-1200",
            "fax_number": "616-588-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARY",
        "first_name": "MONICA",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2018-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301094699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.