Individual provider Active NPI

Jesse Gortner, DO

  • Emergency Medicine Physician
  • Kalamazoo, MI
National Provider Identifier
1790179646
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101024541 Issued in MI
Practice address
1000 Oakland Dr
Kalamazoo, MI 49008-1282
Phone
(269) 337-6604
NPI assigned
Mar 27, 2015
Last updated
Sep 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5101024541 MI
Emergency Medicine Physician 207P00000X 5101024541 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
I20190716002264 MI Practitioner - Emergency Medicine 9032488408 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101024541MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Kalamazoo Inc CurrentSince Nov 9, 2019 Accepting new patients
Beacon Kalamazoo Inc CurrentSince Nov 9, 2019 Accepting new patients
Beacon Kalamazoo Inc Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Vituity-Michigan Health Services PC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Vituity-Michigan Health Services PC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

555 Linn St
Allegan, MI 49010
Phone (269) 673-8424

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

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

4599 Towne Centre Rd
Saginaw, MI 48604
Phone (989) 497-3000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1790179646",
    "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": "269-337-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORTNER",
        "first_name": "JESSE",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-27",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101024541",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101024541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.