Individual provider Active NPI

Elizabeth Ann Kozak, M.D.

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1811076805
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
EK062494 Issued in MI
Practice address
3200 Eagle Park Dr NE
Suite 102
Grand Rapids, MI 49525-7057
Phone
(616) 285-9090
Fax
(616) 285-7947
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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 EK062494 MI Primary

Addresses

Primary practice location

3200 Eagle Park Dr NE
Suite 102
Grand Rapids, MI 49525-7057

Mailing address

3200 Eagle Park Dr NE
Suite 102
Grand Rapids, MI 49525-7057
Phone (616) 285-9090

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
I20070329000031 MI Practitioner - Internal Medicine 9234233388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Cincinnati College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine of West Michigan PLLCGroup PAC ID 9335243484, 6 clinicians
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

3200 Eagle Park Dr NE
Suite 102
Grand Rapids, MI 49525-7057
Phone (616) 285-9090

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

Hospital & facility affiliations

  • Corewell Health Visiting Nurse Association Home health agency, Grand Rapids, MI, CCN 237007
  • Mary Free Bed at Home, LLC Home health agency, Grand Rapids, MI, CCN 237203
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Spectrum Health United Hospital Hospital, Greenville, MI, CCN 230035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
EK062494MIMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: internal.medicine.of.west.michigan@michiganhisp.midirect.net
  • Direct secure messaging: ekozak3363976@epic00.corewelldirect.org

Organizations & group practices 2

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1811076805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 EAGLE PARK DR NE",
            "address_2": "SUITE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257057",
            "telephone_number": "616-285-9090",
            "fax_number": "616-285-7947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 EAGLE PARK DR NE",
            "address_2": "SUITE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257057",
            "telephone_number": "616-285-9090",
            "fax_number": "616-285-7947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "EK062494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.