Ascension Medical Group Promed
Organization Active NPI Internal Medicine Physician · Kalamazoo, MI
NPI 1720009954 · NPPES record last updated Jul 8, 2026
Key facts
- NPI
- 1720009954
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- ASCENSION MEDICAL GROUP PROMED
- Practice address
- 1717 Shaffer St
Ste 124
Kalamazoo, MI 49048-1647 - Phone
- (269) 344-5552
- NPI assigned
- Jul 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Irene Maffetone
- Title
- Manager Contracting and Payor Relat
- Phone
- (574) 647-1040
Other NPIs on the same Medicare enrollment 6
Practitioners 218
-
Michael Lee Adix II, M.D.
-
Ferris Alkazir, MD
-
Yazdi N Amaria, M.D.
-
Susan Ames, ACNP
-
Ashley Armbruster, D.O.
-
Nicholas Badgley, AGACNP
-
Robert Jon Baker, M.D.
-
Kali Barrow, NP
-
Kevin L. Beyer, D.O.
-
Kellie Marie Bowen, PA-C
-
Julie M Bowser, PA-C
-
Pauline U Boy, NP
-
Hunter Geoffrey Brumblay, M.D.
-
Janie Renee Butler, FNP-BC
-
Joyce L Byers, NP
-
Anne M Cavanagh, M.D.
-
Jamie Marie Chapman, FNP-C
-
Sarah Elaine Charters, M.D.
-
Devin Clemence, PA-C
-
Yolanda Cobley, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031216000478 | MI | Part B Supplier - Clinic/Group Practice | 7315856077 |
Receives reassigned benefits from 562 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
Locations
1717 Shaffer St
Ste 2
Kalamazoo, MI 49048
1717 Shaffer St
Ste 124
Kalamazoo, MI 49048
Phone (269) 226-5456
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Family Medicine) Physician |
207QH0002X | MI | ||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Cardiovascular Disease Physician |
207RC0000X | |||
| Gastroenterology Physician |
207RG0100X | |||
| Hospice and Palliative Medicine (Internal Medicine) Physician |
207RH0002X | |||
| Pulmonary Disease Physician |
207RP1001X | |||
| Rheumatology Physician |
207RR0500X | |||
| Neonatal-Perinatal Medicine Physician |
2080N0001X | |||
| Physical Medicine & Rehabilitation Physician |
208100000X | |||
| Neuroradiology Physician |
2085N0700X | |||
| Vascular Surgery Physician |
2086S0129X | |||
| Urology Physician |
208800000X | |||
| Acute Care Nurse Practitioner |
363LA2100X | |||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
1717 Shaffer St
Ste 124
Kalamazoo, MI 49048-1647
Mailing address
3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-2043
Other practice location 1
2845 Capital Ave SW
Battle Creek, MI 49015-4185
Phone (269) 633-2061
Other practice location 2
360 E Chicago St Ste 103
Coldwater, MI 49036-2086
Phone (269) 633-2063
Other practice location 3
711 S Health Parkway
Three Rivers, MI 49093-9387
Phone (269) 633-2070
Other practice location 4
570 Linn St Ste 1
Allegan, MI 49010-1572
Phone (269) 895-0613
Other practice location 5
601 S Health Parkway
Three Rivers, MI 49093-8351
Phone (269) 633-2075
Other practice location 6
1701 Gull Rd
Kalamazoo, MI 49048-1609
Phone (269) 633-2510
Other practice location 7
1815 Henson Ave
Kalamazoo, MI 49048-1510
Phone (269) 633-2513
Other practice location 8
730 Airway Dr
Allegan, MI 49010-8507
Phone (269) 895-0358
Other practice location 9
104 S Lakeview Ave
Sturgis, MI 49091-1947
Phone (269) 633-2068
Other practice location 10
199 Veterans Blvd
South Haven, MI 49090-8652
Phone (269) 633-2066
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 700C910600 | Other | BCBSM | |
| 1720009954 | Medicaid | MI |
Other providers in Kalamazoo, MI
- Ascension Borgess Hospital
- Ascension Borgess Hospital
- Ascension Borgess Hospital
- Ascension Borgess Hospital
- Ascension Medical Group Promed
- Ascent Counseling and Psychological Services, PLLC
- Ramina Asdou
- Hannah Asebes
- Laura Ashack
- Sarah J Ashley
All providers in Kalamazoo, MI · Internal Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.