Individual provider Active NPI

Nicholas John Schneider, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1841312949
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301088169 Issued in MI
Practice address
200 Jefferson SE
Grand Rapids, MI 49503
Phone
(616) 685-5000
Fax
(616) 685-1850
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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 4301088169 MI Primary

Addresses

Primary practice location

200 Jefferson SE
Grand Rapids, MI 49503

Mailing address

245 State St SE
Ste. 221
Grand Rapids, MI 49503
Phone (616) 685-1808

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090828000534 MI Practitioner - HospitalistPractitioner - Internal Medicine 2062567910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Michigan State University College of Human Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-5000

Hospital & facility affiliations

  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059

National Provider Directory

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

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
Saint Mary'S Health Services Past Accepting new patients
Trinity Health - Michigan Past Accepting new patients
Advantage Health Saint Mary'S Medical Group Past 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

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

245 State St SE
Ste 221
Grand Rapids, MI 49503
Phone (616) 685-1808

Organizations & group practices 6

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 1

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1841312949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 STATE ST SE",
            "address_2": "STE. 221",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-685-1808",
            "fax_number": "616-685-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-685-5000",
            "fax_number": "616-685-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301088169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.