| Borgess Lee Medical Group | |
|
520 Main St Ste A Dowagiac MI 49047-1762 | |
| (269) 783-3052 | |
| Not Available |
| Full Name | Borgess Lee Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 520 Main St Ste A, Dowagiac, Michigan |
| Authorized Official Name and Position | Marina Houghton (CFO) |
| Authorized Official Contact | 2692264800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Borgess Lee Medical Group 1717 Shaffer Street Suite 002 Kalamazoo MI 49048 Ph: (269) 552-2830 | Borgess Lee Medical Group 520 Main St Ste A Dowagiac MI 49047-1762 Ph: (269) 783-3052 |
| NPI Number | 1194717504 |
|---|---|
| Provider Enumeration Date | 08/22/2005 |
| Last Update Date | 12/30/2022 |
| Medicare PECOS PAC ID | 7719881002 |
|---|---|
| Medicare Enrollment ID | O20031119000763 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194717504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Michigan) | Primary |
| Provider Name | Anthony King |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194700104 PECOS PAC ID: 9638081367 Enrollment ID: I20040219000026 |
| Provider Name | Ashish P Verma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699735936 PECOS PAC ID: 9537110069 Enrollment ID: I20050202000393 |
| Provider Name | Robert Scott Schaefer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932195393 PECOS PAC ID: 3173417482 Enrollment ID: I20050221000496 |
| Provider Name | Michael Valitutto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326074378 PECOS PAC ID: 1557301520 Enrollment ID: I20050510000022 |
| Provider Name | Modupe A Cassandra Ogunjimi Popoola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427074970 PECOS PAC ID: 5294770160 Enrollment ID: I20050829000507 |
| Provider Name | Kenneth A Jordan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235186438 PECOS PAC ID: 0840187282 Enrollment ID: I20060104000527 |
| Provider Name | Alan Smiy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114965845 PECOS PAC ID: 7517924889 Enrollment ID: I20070118000314 |
| Provider Name | Srinivasan Dhatreecharan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1649379785 PECOS PAC ID: 0042397465 Enrollment ID: I20080410000029 |
| Provider Name | Abbas Syed |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760418198 PECOS PAC ID: 5395749808 Enrollment ID: I20080729000408 |
| Provider Name | Geetha Dhatreecharan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528210556 PECOS PAC ID: 2264591031 Enrollment ID: I20081107000563 |
| Provider Name | Joseph S Mashni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265424527 PECOS PAC ID: 1759439441 Enrollment ID: I20100521000384 |
| Provider Name | Teresita M Villasis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710970488 PECOS PAC ID: 8224167515 Enrollment ID: I20100525000668 |
| Provider Name | Rebecca J Burnau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538482237 PECOS PAC ID: 3072647353 Enrollment ID: I20100823000843 |
| Provider Name | Niaz Mohammad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437352689 PECOS PAC ID: 8224222450 Enrollment ID: I20101102000653 |
| Provider Name | Frank S Saltiel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1215976543 PECOS PAC ID: 4880506500 Enrollment ID: I20101228000656 |
| Provider Name | Aftab Ansari |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124182068 PECOS PAC ID: 2062501661 Enrollment ID: I20110912000030 |
| Provider Name | Jonathan Nykamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144519133 PECOS PAC ID: 3779755939 Enrollment ID: I20111012000084 |
| Provider Name | Robert E Dempsey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942271390 PECOS PAC ID: 0648356337 Enrollment ID: I20111206000748 |
| Provider Name | William S Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659581270 PECOS PAC ID: 0446498893 Enrollment ID: I20130524000599 |
| Provider Name | Melinda S Triemstra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356448054 PECOS PAC ID: 8325286677 Enrollment ID: I20130529000293 |
| Provider Name | Nancy Jo Fantetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891054458 PECOS PAC ID: 0244485639 Enrollment ID: I20130727000175 |
| Provider Name | Michael W Spencer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922424993 PECOS PAC ID: 3577788694 Enrollment ID: I20140703001852 |
| Provider Name | Min Luo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962663906 PECOS PAC ID: 1456543644 Enrollment ID: I20150708001495 |
| Provider Name | Jagadeesh K Kalavakunta |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1457510505 PECOS PAC ID: 5294049367 Enrollment ID: I20150803001316 |
| Provider Name | Victor Benavides-martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518382613 PECOS PAC ID: 0446565543 Enrollment ID: I20150819007050 |
| Provider Name | Julie Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467824284 PECOS PAC ID: 7911217468 Enrollment ID: I20151112001379 |
| Provider Name | Erica L Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275073942 PECOS PAC ID: 7618253055 Enrollment ID: I20170419000644 |
| Provider Name | Theresa I Rinehart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881231090 PECOS PAC ID: 6608204235 Enrollment ID: I20200314000224 |
| Provider Name | Suzanne J Huberty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154718237 PECOS PAC ID: 1557651692 Enrollment ID: I20200727001850 |
| Provider Name | Joseph F Prano |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124447347 PECOS PAC ID: 5193045151 Enrollment ID: I20200909001402 |
| Provider Name | Alicia Jean Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154982783 PECOS PAC ID: 1355728486 Enrollment ID: I20220511001644 |
| Provider Name | Channan Marie Kositzke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831820356 PECOS PAC ID: 9739560145 Enrollment ID: I20220718000193 |
| Provider Name | Nicole Ognjanovski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427610518 PECOS PAC ID: 1850626508 Enrollment ID: I20220726000969 |
Borgess Lee Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 W Division St, Dowagiac, MI 49047 Phone: 269-782-2111 | |
Borgess Lee Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 Main St Ste C, Dowagiac, MI 49047 Phone: 269-783-2080 | |
Borgess Lee Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 W High St, Dowagiac, MI 49047 Phone: 269-782-9200 | |
Boonchoo Chang M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 417 W High St, Dowagiac, MI 49047 Phone: 269-782-7150 Fax: 269-782-7020 | |
Michiana Medical-surgical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 515 Main St, Dowagiac, MI 49047 Phone: 269-782-2273 Fax: 269-782-6682 | |
Borgess Lee Memorial Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 Whitney St, Suite C, Dowagiac, MI 49047 Phone: 269-783-1336 |