Individual provider Active NPI

Benjamin D Willenbring, MD

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1902160385
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301106839 Issued in MI
Practice address
359 Division Ave S
Grand Rapids, MI 49503-4537
Phone
(616) 685-3800
Fax
(616) 235-0913
NPI assigned
Jun 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

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 4301106839 MI Primary

Addresses

Primary practice location

359 Division Ave S
Grand Rapids, MI 49503-4537

Mailing address

1900 44TH St SE
Kentwood, MI 49508-5008

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
I20150618000732 MI Practitioner - Family Practice 6103137054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

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 Jul 1, 2015 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
Advantage Health/Saint Mary'S Medical Group CurrentSince Jul 1, 2015 Accepting new patients
Saint Mary'S Health Services 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

1246 Madison Ave SE
Grand Rapids, MI 49507
Phone (616) 685-8300

359 Division Ave S
Grand Rapids, MI 49503
Phone (616) 643-3800

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

Interoperability endpoints

  • Direct secure messaging: bwillenbring26239@direct.trinity-health.org

Organizations & group practices 5

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": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1902160385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 DIVISION AVE S",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034537",
            "telephone_number": "616-685-3800",
            "fax_number": "616-235-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLENBRING",
        "first_name": "BENJAMIN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301106839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.