Robert R Isacksen, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

4301069750 Issued in MI

Practice address

601 John St
Suite M206C
Kalamazoo, MI 49007-5341

Phone

(269) 349-9745

Fax

(269) 488-8305

NPI assigned

Jun 14, 2006

Last updated

Nov 27, 2023By 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

Other identifiers 5

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@direct.bronsonhg.org
• Direct secure messaging: risacksen10548@direct.bronsonhg.org
• Direct secure messaging: risacksen3233863@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.

• Bronson Lakeview Hospital

  dba Bronson Medical Group

  • Internal Medicine Physician
  • Paw Paw, MI
  • NPI 1235131137
  Medicare reassignment NPD
• Bronson Methodist Hospital

  dba Bronson Medical Group

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137
  Medicare reassignment NPD
• Bronson Lakeview Hospital

  dba Bronson LakeView Family Care-Blue Star

  • Rural Health Clinic/Center
  • South Haven, MI
  • NPI 1801538871
  NPD
• Healthcare Midwest PC

  dba HealthCare Midwest Urology

  • Urology Physician
  • Kalamazoo, MI
  • NPI 1215158191
  NPD (past)
• Healthcare Midwest PC

  dba HealthCare Midwest Hand & Elbow Surgery

  • Orthopaedic Hand Surgery Physician
  • Kalamazoo, MI
  • NPI 1265653158
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1972546059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE M206C",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-349-9745",
            "fax_number": "269-488-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "SUITE M206C",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-349-9745",
            "fax_number": "269-488-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISACKSEN",
        "first_name": "ROBERT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301069750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3358181-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP PIN",
            "identifier": "340C910480",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HLTH PLN",
            "identifier": "114331",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "5735569",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IND PIN",
            "identifier": "3403903262",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Internal Strength Therapy P.L.L.C.
• Sohaib Mehroze Iqbal, MD
• Larry David Irey, PH.D.
• Robin Iriele
• Alexandra Irvine, MS, OTRL
• Angela Isbell
• Mariam M Ischander, M.D.
• Mohammad Asim Ishaq, MD
• Naima Islam, MD
• Wilo Abdul Issack, MD

• Urology Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.