NPIMap

Organization Active NPI

Beacon Kalamazoo Inc

Doing business as Beacon Kalamazoo Bone & Joint Specialists

  • Orthopaedic Surgery Physician
  • Kalamazoo, MI
National Provider Identifier
1780679753
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
392110031 Issued in MI
Legal business name
BEACON KALAMAZOO INC
Doing business as
Beacon Kalamazoo Bone & Joint Specialists
Kalamazoo Orthopaedic Clinic
Practice address
2490 S 11TH St
Suite 201
Kalamazoo, MI 49009-2175
Phone
(269) 343-1535
Fax
(269) 343-0418
NPI assigned
Sep 15, 2005
Last updated
Sep 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Authorized official

Name
Ms. Irene Maffetone
Title
Manager Contracting
Phone
(574) 647-1040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 392110031 MI Primary

Addresses

Primary practice location

2490 S 11TH St
Suite 201
Kalamazoo, MI 49009-2175

Mailing address

3245 Health Dr
Granger, IN 46530-1380
Phone (574) 647-1820

Other identifiers 1

IdentifierTypeStateIssuer
200C976490OtherBCBSM PIN

Other names 2

  • Beacon Kalamazoo Bone & Joint Specialists Doing business as
  • Kalamazoo Orthopaedic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000029 MI Part B Supplier - Clinic/Group Practice 5294645750 Receives reassigned benefits from 305 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kalamazoo, MI; Paw Paw, MI; Plainwell, MI; Portage, MI; South Haven, MI; Sturgis, MI; Three Rivers, MI; Watervliet, MI…

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory
Tax ID family
Brogess Medical Center17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

2490 S 11th St
Ste 201
Kalamazoo, MI 49009
Phone (269) 343-1535

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1780679753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 S 11TH ST",
            "address_2": "SUITE 201",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092175",
            "telephone_number": "269-343-1535",
            "fax_number": "269-343-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON KALAMAZOO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "MAFFETONE",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "MANAGER CONTRACTING",
        "authorized_official_telephone_number": "574-647-1040",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "392110031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "200C976490",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Kalamazoo Bone & Joint Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kalamazoo Orthopaedic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.