Individual provider Active NPI

Jeffrey Bernard Casamento, M.D.

  • Urology Physician
  • Grand Rapids, MI
National Provider Identifier
1780607044
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
JC063636 Issued in MI
Practice address
245 Cherry St SE
Suite 202
Grand Rapids, MI 49503-4607
Phone
(616) 459-3551
Fax
(616) 459-1060
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X JC063636 MI Primary

Addresses

Primary practice location

245 Cherry St SE
Suite 202
Grand Rapids, MI 49503-4607

Mailing address

245 Cherry St SE
Suite 202
Grand Rapids, MI 49503-4607
Phone (616) 459-3551

Other identifiers 1

IdentifierTypeStateIssuer
3046021MedicaidMI

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
I20040621000913 MI Practitioner - Urology 9638154032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Rochester School of Medicine and Dentistry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology Associates PC of Grand RapidsGroup PAC ID 5092783654, 5 clinicians

Practice addresses (Care Compare)

245 Cherry St SE
Suite 202
Grand Rapids, MI 49503-4607
Phone (616) 459-3551

Hospital & facility affiliations

  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Spectrum Health United Hospital Hospital, Greenville, MI, CCN 230035
  • Corewell Health Big Rapids Hospital Hospital, Big Rapids, MI, CCN 230093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
JC063636MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary'S Medical Group CurrentSince Aug 1, 2013 Accepting new patients
Advantage Health/Saint Mary'S Medical Group CurrentSince Aug 1, 2013 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

245 State St SE
Ste 1A
Grand Rapids, MI 49503

Interoperability endpoints

  • Direct secure messaging: jcasamento@uapc.gwaydirect.com

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 5

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1780607044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CHERRY ST SE",
            "address_2": "SUITE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034607",
            "telephone_number": "616-459-3551",
            "fax_number": "616-459-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 CHERRY ST SE",
            "address_2": "SUITE 202",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034607",
            "telephone_number": "616-459-3551",
            "fax_number": "616-459-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASAMENTO",
        "first_name": "JEFFREY",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "JC063636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3046021",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.