Individual provider Active NPI

Erwin Leroy Grasman, MD

  • Family Medicine Physician
  • Muskegon, MI
National Provider Identifier
1780779298
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
EG027041 Issued in MI
Practice address
420 Whitehall Rd
Muskegon, MI 49445
Phone
(231) 744-4743
Fax
(231) 744-4745
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X EG027041 MI Primary

Addresses

Primary practice location

420 Whitehall Rd
Muskegon, MI 49445

Mailing address

420 Whitehall Rd
Muskegon, MI 49445
Phone (231) 744-4743

Other identifiers 3

IdentifierTypeStateIssuer
0F16019OtherMIBCBS
1435450MedicaidMI
0F16019OtherMIPRIORITY HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
EG027041MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WKQ, Inc Family Medicine CurrentSince Jan 24, 1983 Accepting new patients

Locations

1890 E Apple Ave
Muskegon, MI 49442
Phone (231) 724-3500

420 Whitehall Rd
Ste 4
North Muskegon, MI 49445
Phone (231) 744-4743

420 Whitehall Rd
North Muskegon, MI 49445
Phone (231) 744-4743

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1780779298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 WHITEHALL RD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "49445",
            "telephone_number": "231-744-4743",
            "fax_number": "231-744-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 WHITEHALL RD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "49445",
            "telephone_number": "231-744-4743",
            "fax_number": "231-744-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRASMAN",
        "first_name": "ERWIN",
        "middle_name": "LEROY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "EG027041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0F16019",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1435450",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "0F16019",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.