| Dr Mark Ryan Nikkel, DO | |
|
955 S Bailey Ave, South Haven, MI 49090-6743 | |
| (269) 637-5271 | |
| (269) 639-2818 |
| Full Name | Dr Mark Ryan Nikkel |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 24 Years |
| Location | 955 S Bailey Ave, South Haven, 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 |
|---|---|---|---|
| 1699762336 | NPI | - | NPPES |
| 1023138633 | Other | IL | GROUP NPI NUMBER |
| 31622992 | Other | IL | BCBS |
| 036-100980 | Other | IL | STATE LICENSE NUMBER |
| 036100980 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 36100980 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bronson South Haven Hospital | South haven, MI | Hospital |
| Bronson Lakeview Hospital | Paw paw, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bronson South Haven Hospital | 6204724834 | 33 |
| Entity Name | Bronson South Haven Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174749170 PECOS PAC ID: 6204724834 Enrollment ID: O20040305001005 |
| Entity Name | Bronson Lakeview Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235131137 PECOS PAC ID: 9032008495 Enrollment ID: O20051027001022 |
| Entity Name | Bronson Lakeview Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1962508259 PECOS PAC ID: 9032008495 Enrollment ID: O20080516000276 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark Ryan Nikkel, DO 955 S Bailey Ave, South Haven, MI 49090-6743 Ph: (269) 637-5271 | Dr Mark Ryan Nikkel, DO 955 S Bailey Ave, South Haven, MI 49090-6743 Ph: (269) 637-5271 |
Dr. Nicholas Loafman, D.O Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 955 S Bailey Ave, South Haven, MI 49090 Phone: 269-639-2866 Fax: 269-639-2864 |