Individual provider Active NPI

Byron L Varnado, MD

  • Family Medicine Physician
  • Muskegon, MI
National Provider Identifier
1962405357
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BV068517 Issued in MI
Practice address
1675 Leahy St
Ste 301
Muskegon, MI 49442-5543
Phone
(231) 728-5002
Fax
(231) 728-5041
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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 BV068517 MI Primary

Addresses

Primary practice location

1675 Leahy St
Ste 301
Muskegon, MI 49442-5543

Mailing address

PO Box 1848
Muskegon, MI 49443-1848
Phone (231) 727-4444

Other practice location 1

1675 Leahy St Ste 103
Muskegon, MI 49442-5538
Phone (231) 737-1335

Other identifiers 2

IdentifierTypeStateIssuer
104556370MedicaidMI
1962405357MedicaidMI

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
I20031223000718 MI Practitioner - Family Practice 3678471992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackley Community Care Center IncGroup PAC ID 8123015492, 18 clinicians

Practice addresses (Care Compare)

1675 Leahy St
Suite 103
Muskegon, MI 49442-5538
Phone (231) 733-6901

Hospital & facility affiliations

  • Harbor Hospice Hospice, Muskegon, MI, CCN 231508
  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BV068517MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackley Community Care Center Inc Family Medicine CurrentSince Oct 26, 2020 Accepting new patients
Hackley Community Care Center, Inc CurrentSince Oct 26, 2020 Accepting new patients
Advantage Health Saint Mary'S Medical Group Past Accepting new patients
HPCN Family Medicine Past Accepting new patients

Locations

1675 Leahy St
Ste 301A
Muskegon, MI 49442
Phone (231) 672-8300

1550 Clinton St
Muskegon, MI 49442
Phone (231) 733-6910

1675 Leahy St
Ste 103
Muskegon, MI 49442
Phone (231) 728-4915

1675 Leahy St
Ste 301
Muskegon, MI 49442
Phone (231) 728-5006

2700 Baker St
Fl 3
Muskegon Heights, MI 49444
Phone (231) 733-6607

Organizations & group practices 4

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 2

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": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1962405357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1848",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431848",
            "telephone_number": "231-727-4444",
            "fax_number": "231-727-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST",
            "address_2": "STE 301",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425543",
            "telephone_number": "231-728-5002",
            "fax_number": "231-728-5041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Leahy St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Muskegon",
            "state": "MI",
            "postal_code": "494425538",
            "country_code": "US",
            "telephone_number": "231-737-1335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARNADO",
        "first_name": "BYRON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "BV068517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104556370",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962405357",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.