| Dr Mark A Dittenbir, MD | |
|
601 John St Ste M283a, Kalamazoo, MI 49007-5341 | |
| (269) 349-7696 | |
| (269) 488-8313 |
| Full Name | Dr Mark A Dittenbir |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 41 Years |
| Location | 601 John St Ste M283a, Kalamazoo, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942249727 | NPI | - | NPPES |
| 020C91020 | Other | MI | BCBS GRP PIN |
| 3403901640 | Other | MI | BCBS IND PIN |
| 5515041 | Other | AETNA PIN | |
| 116658 | Other | GREAT LAKES HLTH PLN | |
| 1417961137 | Other | MI | BCBSM - BRONSON |
| 1942249727 | Medicaid | MI | |
| 3218986-10 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | 4301048692 (Michigan) | Secondary |
| 208600000X | Surgery | 4301048692 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Chi St Alexius Health | Bismarck, ND | Hospital |
| Lakeland Hospital, St Joseph | St joseph, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lakeland Medical Practices | 1658427042 | 252 |
| Scl Health Medical Group-butte Llc | 2466633102 | 82 |
| St Alexius Medical Center | 8426960865 | 225 |
| Entity Name | Bronson Methodist Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417961137 PECOS PAC ID: 0244148633 Enrollment ID: O20031208000832 |
| Entity Name | Lakeland Medical Practices |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538397120 PECOS PAC ID: 1658427042 Enrollment ID: O20090928000216 |
| Entity Name | Acute Care Surgery Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700069549 PECOS PAC ID: 7214006816 Enrollment ID: O20180514000575 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark A Dittenbir, MD 601 John St, Suite M283a, Kalamazoo, MI 49007-5341 Ph: (269) 349-7696 | Dr Mark A Dittenbir, MD 601 John St Ste M283a, Kalamazoo, MI 49007-5341 Ph: (269) 349-7696 |
Dr. Kibwe Akin Weaver, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 601 John St, Suite M-283, Kalamazoo, MI 49007 Phone: 269-488-1524 Fax: 269-488-1655 | |
Dr. Stephen Todd Wysong, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 601 John St, Suite M-283, Kalamazoo, MI 49007 Phone: 269-349-7696 Fax: 269-349-0610 | |
Dr. Krishna Mohan Jain, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1815 Henson Ave, Kalamazoo, MI 49048 Phone: 269-492-6500 Fax: 269-492-6461 | |
Dr. David Brandon Minnick, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 601 John St, Suite M-283, Kalamazoo, MI 49007 Phone: 269-349-7696 Fax: 269-488-8313 | |
Marc Thomas Downing, MD Surgery Medicare: Medicare Enrolled Practice Location: 601 John St, Suite M351, Kalamazoo, MI 49007 Phone: 269-341-6900 Fax: 269-341-7883 | |
Jason Thomas Ryan, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1535 Gull Rd Ste 20, Kalamazoo, MI 49048 Phone: 269-381-4577 | |
James Bailey Babel, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 1717 Shaffer St, Suite 108, Kalamazoo, MI 49048 Phone: 269-343-9113 Fax: 269-343-0510 |