Individual provider Active NPI

Cameron Richardson, D.O.

  • Diagnostic Radiology Physician
  • Grand Rapids, MI
National Provider Identifier
1720442015
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
5101026715 Issued in MI
Practice address
200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone
(616) 279-3105
NPI assigned
Apr 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 5101026715 MI Primary

Addresses

Primary practice location

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502

Mailing address

PO Box 5329
Saginaw, MI 48603-0329
Phone (616) 364-6700

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
I20220517000291 MI Practitioner - Diagnostic Radiology 5890087811 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kent Radiology PCGroup PAC ID 0648171850, 18 clinicians

Practice addresses (Care Compare)

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-5907

Hospital & facility affiliations

  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

Merit-based Incentive Payment System (MIPS)

Final score
87.91 of 100Reported as group
Quality
83.03
Promoting interoperability
100
Improvement activities
40
Cost
76.65

Merit-based Incentive Payment System (MIPS)

Final score
87.57 of 100Reported as group
Quality
85
Improvement activities
40
Cost
76.83

Merit-based Incentive Payment System (MIPS)

Final score
81.25 of 100Reported as group
Quality
96.84
Promoting interoperability
100
Improvement activities
40
Cost
40.67

Merit-based Incentive Payment System (MIPS)

Final score
93.89 of 100Reported as group
Quality
95.63
Promoting interoperability
100
Improvement activities
40
Cost
84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101026715MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince May 11, 2024 Accepting new patients
Bronson Lakeview Hospital CurrentSince May 11, 2024 Accepting new patients
Bronson Battle Creek Hospital CurrentSince May 11, 2024 Accepting new patients
Bronson South Haven Hospital CurrentSince May 11, 2024 Accepting new patients
Bronson Battle Creek Hospital CurrentSince May 11, 2024 Accepting new patients
Bronson Lakeview Hospital CurrentSince May 11, 2024 Accepting new patients
Bronson South Haven Hospital CurrentSince May 11, 2024 Accepting new patients
Kent Radiology PC Diagnostic Radiology CurrentSince Jul 5, 2022 Accepting new patients
Art of Radiology Imaging Associates, PLLC Diagnostic Radiology Past Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

300 North Ave
Battle Creek, MI 49017
Phone (269) 966-8000

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

955 S Bailey Ave
South Haven, MI 49090
Phone (269) 637-5271

950 S Bailey Ave
South Haven, MI 49090
Phone (269) 639-2796

Interoperability endpoints

  • Direct secure messaging: crichardson1847634@direct.trinity-health.org

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1720442015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5329",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486030329",
            "telephone_number": "616-364-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-279-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "CAMERON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-12",
        "last_updated": "2023-01-06",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101026715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.