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ACADEMIC SURGICAL ASSOCIATES PLLC NPI 1114139045


NPI Information

NPI: 1114139045
Provider Name: ACADEMIC SURGICAL ASSOCIATES, PLLC
Classification: Surgery - 2086X0206X
Entity Type: Organization

Specialization: Surgical Oncology

Address:
1000 E PARIS AVE SE
SUITE 150
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 977-6243
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ACADEMIC SURGICAL ASSOCIATES, PLLC is a surgical oncology surgery in Grand Rapids, MI. The provider is a surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. ACADEMIC SURGICAL ASSOCIATES, PLLC NPI is 1114139045. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1000 E PARIS AVE SE
SUITE 150
GRAND RAPIDS, MI
ZIP 49546-691
Phone: (616) 977-6243
Fax: (616) 977-0396

The provider's authorized official is David E Scheeres .
The authorized official title is President and has the following contact phone number (616) 977-3990.

The enumeration date for this NPI number is 5/4/2007 and was last updated on 8/6/2007.


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
12086X0206XSurgerySurgical OncologyYes

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
1B18045MEDICARE UPINMICHIGAN
20N90160MEDICARE ID-TYPE UNSPECIFIEDMICHIGANMEDICARE GROUP
3N90160004MEDICARE ID-TYPE UNSPECIFIEDMICHIGANVANDERKOLK INDIVUDAL MR
4N90160003MEDICARE ID-TYPE UNSPECIFIEDMICHIGANLANGE INDIVIDUAL MR
54745617MEDICAIDMICHIGAN
64745635MEDICAIDMICHIGAN
74745608MEDICAIDMICHIGAN
8700D11379OTHERMICHIGANBCBS GROUP NUMBER
9G53702MEDICARE UPINMICHIGAN
10N90160001MEDICARE ID-TYPE UNSPECIFIEDMICHIGANSCHEERES INDIVIDUAL MR
11N90160002MEDICARE ID-TYPE UNSPECIFIEDMICHIGANSCHOLTEN INDIVIDUAL MR
124736850MEDICAIDMICHIGAN
13B48400MEDICARE UPINMICHIGAN
14A76692MEDICARE UPINMICHIGAN

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

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