Individual provider Active NPI

Eric John Edewaard, MD

  • Internal Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1780175851
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301505065 Issued in MI
Practice address
1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone
(269) 337-6300
Fax
(269) 337-6222
NPI assigned
May 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301505065 MI Primary

Addresses

Primary practice location

1000 Oakland Dr
Kalamazoo, MI 49008-1282

Mailing address

1000 Oakland Dr
Kalamazoo, MI 49008-1282

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
I20210803003649 MI Practitioner - Internal Medicine 9133484504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Michigan University School of MedicineGroup PAC ID 7517113954, 76 clinicians

Practice addresses (Care Compare)

1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone (269) 337-4347

Hospital & facility affiliations

  • Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017

Merit-based Incentive Payment System (MIPS)

Final score
97.1 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.4

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301505065MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Michigan University School of Medicine CurrentSince Aug 30, 2021 Accepting new patients
Michigan State University Kalamazoo Center for Medical Studies Current Accepting new patients
Ascension Borgess Hospital Past Accepting new patients
Bronson Methodist Hospital Past Accepting new patients

Locations

1000 Oakland Dr
Kalamazoo, MI 49008
Phone (269) 337-4347

1000 Oakland Dr
Fl 3
Kalamazoo, MI 49008
Phone (269) 387-7004

Organizations & group practices 4

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": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1780175851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 OAKLAND DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OAKLAND DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081282",
            "telephone_number": "269-337-6300",
            "fax_number": "269-337-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEWAARD",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301505065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.