Kostadinos Vergos, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5151015241 Issued in MI

Practice address

3443 Farr Rd
Fruitport, MI 49415-8779

Phone

(231) 672-2900

NPI assigned

May 3, 2021

Last updated

May 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLaren FlintGroup PAC ID 8628975497, 144 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Home Health Home health agency, Davison, MI, CCN 237010
• McLaren Flint Hospital, Flint, MI, CCN 230141
• Memorial Healthcare Hospital, Owosso, MI, CCN 230121

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kvergos1036851@direct.trinity-health.org

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.

• McLaren Flint

  • General Practice Physician
  • Flint, MI
  • NPI 1275807372

  Family Medicine

  Medicare reassignment Care Compare group NPD
• McLaren Flint

  • Social Worker
  • Flint, MI
  • NPI 1356480685
  NPD
• McLaren Flint

  • Internal Medicine Physician
  • Flint, MI
  • NPI 1154469229
  NPD (past)
• McLaren Medical Group

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1073650750
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLaren Flint

  • General Acute Care Hospital
  • Flint, MI
  • NPI 1902894512
  Care Compare affiliation
• McLaren Health Management Group

  dba McLaren Home Health

  • Home Health Agency
  • Davison, MI
  • NPI 1023059144
  Care Compare affiliation
• Memorial Hospital

  dba Memorial Healthcare

  • General Acute Care Hospital
  • Owosso, MI
  • NPI 1063414233
  Care Compare affiliation

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1942883442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST STE 315A",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 FARR RD",
            "city": "FRUITPORT",
            "state": "MI",
            "postal_code": "494158779",
            "telephone_number": "231-672-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGOS",
        "first_name": "KOSTADINOS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151015241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie Tubbs, BS, CTRS, CDP
• Chad Uptigrove, DO
• Kristina Demitra Valkanas, M.D.
• Valparaiso Integrated Services, Inc.
• Hannah Vegh, LLMSW
• W Richard Harris MD LLC
• Kristen M Wagner, D.O.
• Christine Ann Wiswell, R.T.R.
• Kristen Kay Woods, MD
• X-Cell Integrative Health PC

• Family Medicine Physician in Fruitport, MI
• Providers in Fruitport, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.