Active NPI
Corey B Schaedig, PA
- Medical Physician Assistant
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5601004511
- Practice address
- 200 Jefferson Ave SE
Grand Rapids, MI 49503-4502 - Phone
- (616) 942-9610
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601004511 | MI | |
| Medical Physician Assistant | 363AM0700X | 5601004511 | MI | Primary |
Addresses
Primary practice location
200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Mailing address
PO Box Q
Grand Rapids, MI 49501-4917
Phone (800) 968-6866
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00321467 | Other | RAILROAD MEDICARE |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Jefferson Ave SE
Mercy Health St. Mary'S
Grand Rapids, MI 49503-4502
Phone (616) 685-5000
6050 Northland Dr NE
Trinity Health St Marys
Rockford, MI 49341-9256
Phone (616) 685-5000
Hospital & facility affiliations
- Mercy Health Saint Mary'S
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601004511 | MI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advantage Health/Saint Mary'S Medical Group | Current | Accepting new patients | |
| Advantage Health Saint Mary'S Medical Group | Physician Assistant | Current | 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
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.
-
- Emergency Medicine Physician
- Grand Rapids, MI
- NPI 1114929353
-
- Multi-Specialty Clinic/Center
- Grand Rapids, MI
- NPI 1376862151
-
- Orthopaedic Surgery Physician
- Byron Center, MI
- NPI 1003515008
Physician Assistant
-
- Clinic/Center
- Sparta, MI
- NPI 1760599906
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1639111057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1962414953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX Q",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495014917",
"telephone_number": "800-968-6866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 JEFFERSON AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034502",
"telephone_number": "616-942-9610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHAEDIG",
"first_name": "COREY",
"middle_name": "B",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601004511",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601004511",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00321467",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.