NPIMap

Organization Active NPI

Macatawa Anesthesia PC

  • Anesthesiology Physician
  • Holland, MI
National Provider Identifier
1942242136
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MACATAWA ANESTHESIA PC
Practice address
602 Michigan Ave
Holland, MI 49423-4918
Phone
(616) 392-5141
NPI assigned
Jun 12, 2006
Last updated
Feb 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Authorized official

Name
Frederick Ganzi, MDNPI 1639105646
Title
Authorized Official
Phone
(616) 399-4946

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary
Certified Registered Nurse Anesthetist 367500000X NU

Addresses

Primary practice location

602 Michigan Ave
Holland, MI 49423-4918

Mailing address

588 E 40TH St
Suite C
Holland, MI 49423-5367
Phone (616) 399-4946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041228000770 MI Part B Supplier - Clinic/Group Practice 4183682883 Receives reassigned benefits from 18 practitioners
Practice locations: Holland, MI
O20051024000107 MI Part B Supplier - Clinic/Group Practice 4183682883 Receives reassigned benefits from 20 practitioners
Practice locations: Holland, MI

National Provider Directory

National Provider Directory

Locations

588 E 40th St
Ste C
Holland, MI 49423
Phone (616) 399-4946

Practitioners & affiliated clinicians

Practitioners 54

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1942242136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 E 40TH ST",
            "address_2": "SUITE C",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494235367",
            "telephone_number": "616-399-4946",
            "fax_number": "616-399-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234918",
            "telephone_number": "616-392-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACATAWA ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "GANZI",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "616-399-4946",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.