NPIMap

Organization Active NPI

Mid-Michigan Radiology Associates, PC

  • Diagnostic Radiology Physician
  • Alma, MI
National Provider Identifier
1770740581
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MID-MICHIGAN RADIOLOGY ASSOCIATES, PC
Practice address
300 Warwick
Alma, MI 48801-1014
Phone
(989) 466-3342
Fax
(989) 466-7250
NPI assigned
May 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Authorized official

Name
Mr. Johannes Buiteweg, MD
Title
President
Phone
(989) 773-2018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

300 Warwick
Alma, MI 48801-1014

Mailing address

PO Box 30516
Dept 6086
Lansing, MI 48909-8016
Phone (989) 466-3342

Other identifiers 1

IdentifierTypeStateIssuer
300B960080OtherMIBCBS OF MICHIGAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041103000655 MI Part B Supplier - Clinic/Group Practice 5991767782 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Bay City, MI; Mt Pleasant, MI; Mount Pleasant, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Mid Michigan Radiology Associates PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1770740581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "address_2": "DEPT 6086",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489098016",
            "telephone_number": "989-466-3342",
            "fax_number": "989-466-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WARWICK",
            "city": "ALMA",
            "state": "MI",
            "postal_code": "488011014",
            "telephone_number": "989-466-3342",
            "fax_number": "989-466-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MICHIGAN RADIOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "BUITEWEG",
        "authorized_official_first_name": "JOHANNES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-773-2018",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "300B960080",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alma, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.