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EDWIN T KORNOELJE D.O.
NPI 1023071727
Family Medicine - Sports Medicine in Grand Rapids, MI

Active since April 11, 2006PECOS EnrolledAccepts Medicare Assignment
4300 CASCADE RD SE, GRAND RAPIDS, MI 49546(616) 252-1500(616) 252-1599 Get Directions Write a Review

NPPES record last updated: December 5, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 5, 2017, Feb 17, 2017, Oct 31, 2016 (3 updates tracked since 2016).

About Edwin T Kornoelje D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDWIN T KORNOELJE D.O. (NPI 1023071727) is an individual sports medicine provider in Grand Rapids, Michigan, licensed in Michigan (5101012620) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with University Of Michigan Health - West, and is a graduate of Michigan State University College Of Osteopathic Medicine (1995).

NPPES Registry Identity

NPI1023071727
Entity TypeIndividualMale
Primary Taxonomy207QS0010X
Provider Legal NameEDWIN T KORNOELJECredential: D.O.
Location Address4300 CASCADE RD SEGrand Rapids, MI 49546-8328
Mailing Address5900 Byron Center Ave Sw, Medical AdministrationWyoming, MI 49519-9606 · (616) 252-3243 · Fax (616) 252-0260
Phone(616) 252-1500
Fax(616) 252-1599
Sole ProprietorNo
Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 1995
Enumeration DateApril 11, 2006
Last NPPES UpdateDecember 5, 20173 updates tracked since enumeration
✔ NPI 1023071727 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in MI · 5101012620
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 5101012620 (MI)
Also ListedPhysical Medicine & Rehabilitation · Sports MedicineTaxonomy 2081S0010X · License 5101012620 (MI)
4300 CASCADE RD SE, Grand Rapids, MI 49546
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Edwin T Kornoelje D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8224008404
PECOS Enrollment IDI20040727000258
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
49 services38 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
30 services26 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
29 services14 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
17 services17 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Michigan Health - West

Acute Care Hospitals · Wyoming, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230236
Location5900 Byron Center Avenue, SWWyoming, MI 49519 · Kent County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49546 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers16 claims43 services$5.51 avg. paid by Medicare
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630
DME-Other DME · category DE000N
2 suppliers11 claims11 services$34.79 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTI KERN D.O.
Family Medicine
4300 CASCADE RD SE
GRAND RAPIDS, MI 49546
Kent County (616) 252-1500
JENNIFER ANNE CORY DO
Internal Medicine
4300 CASCADE RD SE
GRAND RAPIDS, MI 49546
Kent County (616) 252-1500
ANUSHA KUMBAM MD
Internal Medicine
4300 CASCADE RD SE
GRAND RAPIDS, MI 49546
Kent County (616) 252-1500
HEATHER DICKINSON PA-C
Physician Assistant
4300 CASCADE RD SE
GRAND RAPIDS, MI 49546
Kent County (616) 252-1500
DR. ADAM TROY WOLFE DO
Internal Medicine
4300 CASCADE RD SE
GRAND RAPIDS, MI 49546
Kent County (616) 252-1500
ELIZABETH WILSON
Nurse Practitioner (Family)
4300 CASCADE RD SE
GRAND RAPIDS, MI 49546
Kent County (616) 252-1500
DAVID G FRYE PC
Orthopaedic Surgery
4300 CASCADE RD SE, SUITE 103
GRAND RAPIDS, MI 49546
Kent County (616) 243-7900
SARAH R LUTZ
Nurse Practitioner
4300 CASCADE RD SE
GRAND RAPIDS, MI 49546
Kent County (616) 525-1500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edwin Kornoelje's NPI number?

The NPI number for Edwin Kornoelje is 1023071727. It was assigned to this individual provider in the NPPES registry on April 11, 2006.

Where is Edwin Kornoelje located?

Edwin Kornoelje practices at 4300 Cascade Rd SE, Grand Rapids, MI 49546. The listed phone number is (616) 252-1500.

What is Edwin Kornoelje's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Edwin Kornoelje enrolled in Medicare?

Yes. Edwin Kornoelje is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Edwin Kornoelje accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Edwin Kornoelje as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Edwin Kornoelje affiliated with any hospitals?

According to CMS data, Edwin Kornoelje is affiliated with University Of Michigan Health - West.

When was this NPI record last updated?

The NPPES record for Edwin Kornoelje was last updated on December 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.