ASCENSION MEDICAL GROUP GENESYS (NPI# 1205304888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205304888 |
| Entity Type | Organization |
| Organization Name | ASCENSION MEDICAL GROUP GENESYS |
| Other Organization Name | ASCENSION GENESYS AMBULATORY IMAGING |
| Practice Address |
1096 S Belsay Rd Ste J Burton MI 48509-1948 |
| Mailing Address |
3495 S Center Rd Burton MI 48519-1455 |
| Practice Telephone | 8107150803 |
| Practice Fax Number | 8107150824 |
| Mailing Telephone | 8104242136 |
| Enumeration Date | 2018-11-13 |
| Last Update Date | 2020-08-18 |
| Authorized Official Name | RANDOLPH KUMMLER (CEO) |
| Authorized Official Telephone | 8104242136 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Ascension Genesys Ambulatory Imaging | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114495793 | Ascension Medical Group Genesys | Occupational Therapist | 1096 S Belsay Rd Ste G, Burton, MI 48509-1948 | 2018-11-13 |
| 1982170312 | Ascension Medical Group Genesys | Internal Medicine | 1096 S Belsay Rd Ste C, Burton, MI 48509-1948 | 2018-10-24 |
| 1598248718 | Ascension Medical Group Genesys | Internal Medicine | 3495 S Center Rd, Burton, MI 48519-1455 | 2018-09-13 |
| 1215410436 | Ascension Medical Group Genesys | Internal Medicine | 3495 S Center Rd, Burton, MI 48519-1455 | 2018-09-13 |
| 1003398470 | Ascension Medical Group Genesys | Internal Medicine | 4485 E Mount Morris Rd, Mount Morris, MI 48458-8963 | 2018-09-03 |
| Street Address |
1096 S BELSAY RD STE J |
| City | BURTON |
| State | MI |
| Zip Code | 48509-1948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194346486 | Katherine A Mieczkowski | Hearing Instrument Specialist | 235 S. Center #7, Burten, MI 48509 | 2020-04-28 |
| 1538657697 | Jenny Dudley | Nurse Practitioner | 1501 Center Rd, Burton, MI 48509 | 2018-04-24 |
| 1831618289 | Michael T Sproule | Registered Nurse | 6201 Woodmoor Dr, Burton, MI 48509 | 2017-09-18 |
| 1083159438 | William H Moon Jr Dds | Dentist | 1481 South Center Road, Burton, MI 48509 | 2016-12-21 |
| 1922419464 | David Peter Luebbert | Family Medicine | 1460 N. Center Rd., Burton, MI 48509 | 2014-05-19 |
| 1760722896 | Ambe Inc. | Pharmacy | 6009 E. Lapeer Rd, Burton, MI 48509 | 2013-02-27 |
| 1669519328 | Planned Parenthood Mid and South Michigan | Clinic/Center | G1235 S Center Rd, Unit #17, Burton, MI 48509 | 2007-01-31 |
| 1073689899 | Tender Dental Care PC | Dentist | 1024 N Genesee, Burton, MI 48509 | 2006-11-24 |
| 1043385701 | William H Moon Jr. | Dentist | 1481 S Center Rd, Burton, MI 48509 | 2006-11-21 |
| 1679669485 | Todd William Lee | Optometrist | 5323 E. Court St. N., Burton, MI 48509 | 2006-10-05 |
| Find all providers in zip 48509 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114015898 | Peter K Mcleod | Radiology | 1198 N Belsay Rd Bldg 2, Burton, MI 48509-1669 | 2006-10-10 |
| 1831106301 | Kyung-woong Moon | Radiology | 1096 S Belsay Rd, Suite J, Burton, MI 48509-1948 | 2006-08-01 |
| 1700166733 | Chaitanya Vemulapalli | Radiology | 1096 S Belsay Rd, Ste J, Burton, MI 48509-1948 | 2011-08-22 |
| 1093962342 | Mid Michigan Diagnostic Corp | Radiology | 1513 S Center Rd, Burton, MI 48509-1728 | 2008-08-19 |
| 1205925609 | Roentgen Associates, P.C. | Radiology | 1198 N Belsay Rd Bldg 2, Burton, MI 48509-1669 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855667 | Joshua Boulter | Radiology | 2250 Providence Drive, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-11 |
| 1679197693 | Shyam Amin | Radiology | Academic Internal Medicine 2 2250 Providence Dr, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-05 |
| 1871116509 | Anthony Diebes | Radiology | 16001 W 9 Mile Rd Bldg 4th, Southfield, MI 48075-4818 | 2020-05-28 |
| 1548823800 | Alexander Paul Kaechele | Radiology | 16001 West 9 Mile Road, Suite #416, Southfield, MI 48075-4818 | 2019-04-22 |
| 1790246627 | Genesis Healthcare | Radiology | 8560 N Silvery Ln Ste 101, Dearborn Heights, MI 48127-4516 | 2019-03-25 |
| 1023572831 | Proscan Imaging Southfield Pllc | Radiology | 29877 Telegraph Rd # 11, Southfield, MI 48034-1332 | 2019-01-25 |
| 1295204253 | Easy Imaging, LLC | Radiology | 16100 19 Mile Rd Ste X, Clinton Township, MI 48038-1148 | 2018-11-20 |
| 1336626696 | Quantum Medical Radiology of California, P.C. | Radiology | 1625 Bear Creek Ln Unit O, Petoskey, MI 49770-8378 | 2018-07-19 |
| 1376072488 | Cambridge Institute of Minimally Invasive Therapies Pllc | Radiology | 2007 E 14 Mile Rd, Sterling Heights, MI 48310-5905 | 2017-06-12 |
| 1336693993 | Riverside Radiology Medical Group, Inc | Radiology | 3309 Squirrel Rd, Bloomfield, MI 48304-2456 | 2016-08-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.