Provider Type Icon

DR. STEPHEN TODD WYSONG M.D. NPI 1013952985


NPI Information

NPI: 1013952985
Provider Name: DR. STEPHEN TODD WYSONG, M.D.
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

PECOS Registration: Yes

Address:
601 JOHN ST
SUITE M-283
KALAMAZOO, MI
ZIP 49007
Phone: (269) 349-7696
Get Directions

DR. Stephen Todd Wysong, M.D. is a vascular surgery surgery in Kalamazoo, MI with 33 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. DR. Stephen Todd Wysong, M.D. NPI is 1013952985. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1991

The provider's business location address is:

601 JOHN ST
SUITE M-283
KALAMAZOO, MI
ZIP 49007-341
Phone: (269) 349-7696
Fax: (269) 349-0610

The NPI 1013952985 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasound of head and neck (HCPCS:76536)

The enumeration date for this NPI number is 6/17/2006 and was last updated on 11/27/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgery4301058092MICHIGANNo
22086S0129XSurgeryVascular Surgery4301058092MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13279453-10MEDICAIDMICHIGAN
23403903000OTHERMICHIGANBCBS IND PIN
3112048OTHERGREAT LAKES HLTH PLN
45898515OTHERAETNA PIN
5020C91020OTHERMICHIGANBCBS GRP PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.