Individual provider Active NPI

Lesli A Casten, MD

  • Family Medicine Physician
  • Holland, MI
National Provider Identifier
1992089965
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301114002 Issued in MI
Practice address
3290 N Wellness Dr Ste 220
Holland, MI 49424-7261
Phone
(616) 685-7450
Fax
(616) 685-7455
NPI assigned
Oct 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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 4301114002 MI Primary

Addresses

Primary practice location

3290 N Wellness Dr Ste 220
Holland, MI 49424-7261

Mailing address

1900 44TH St SE
Kentwood, MI 49508-5008

Other names 1

  • Lesli A Munoz Former name

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
I20180221000600 MI Practitioner - Family Practice 6103087234 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health/Saint Mary'S Medical Group CurrentSince Mar 26, 2018 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Mar 26, 2018 Accepting new patients
KMG Medical Group Mo, P.C. Family Medicine Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

3290 N Wellness Dr
Ste 220
Holland, MI 49424
Phone (616) 685-7450

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1992089965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 N WELLNESS DR STE 220",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494247261",
            "telephone_number": "616-685-7450",
            "fax_number": "616-685-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTEN",
        "first_name": "LESLI",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301114002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLI",
            "last_name": "MUNOZ",
            "middle_name": "A",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.