BRONSON MEDICAL GROUP
NPI 1174749170
Family Medicine in South Haven, MI
About Bronson Medical Group NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRONSON MEDICAL GROUP (NPI 1174749170) is a healthcare organization registered as a family medicine in South Haven, Michigan and active in the NPI registry since April 2007. The organization holds 2 active CLIA laboratory certificates and lists Rebecca L East, Svp, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Names 1
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bronson Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
190Medicare enrollment records show 190 clinicians reassign Medicare billing to Bronson Medical Group, which bills Medicare for the services they deliver. Of these, 12 practice at this address and 26 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 17
Nearest to this location (20)
See all 190Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Accreditation 23D0378033
Bronson South Haven Hospital · South Haven, MICertificate of Waiver 23D2222155
Bronson South Haven Hospital Ancillary Testing · South Haven, MIFrequently 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 Bronson South Haven Hospital's NPI number?
The NPI number for Bronson South Haven Hospital is 1174749170. It was assigned to this organization in the NPPES registry on April 18, 2007. The provider is doing business as Bronson Medical Group.
Where is Bronson South Haven Hospital located?
Bronson South Haven Hospital is located at 950 S Bailey Ave, South Haven, MI 49090. The listed phone number is (269) 637-5271.
What is Bronson South Haven Hospital's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Bronson South Haven Hospital enrolled in Medicare?
Yes. Bronson South Haven Hospital is registered in the Medicare PECOS enrollment system.
When is Bronson South Haven Hospital's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Bronson South Haven Hospital?
According to the CMS Revalidation Reassignment List (October 2026 release), 190 clinicians in 17 Medicare specialties reassign their Medicare billing to Bronson South Haven Hospital. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (38), Nurse Practitioner (30) and Internal Medicine (20). Of these, 12 practice at this address and 26 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Bronson South Haven Hospital hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Bronson South Haven Hospital accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Bronson South Haven Hospital 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.
When was this NPI record last updated?
The NPPES record for Bronson South Haven Hospital was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Bronson Medical Group · NPI 1174749170
Family Medicine organization in South Haven, Michigan. Organization record, active in the CMS NPPES registry since April 18, 2007.
## Identity
- **NPI:** 1174749170 (Entity type: Organization)
- **Enumerated:** April 18, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Bronson South Haven Hospital
- **Organization subpart:** No
- **Authorized official:** Rebecca East, SVP, CFO
## Practice location
- **Address:** 950 S BAILEY AVE, South Haven, MI 49090-8744
- **Phone:** (269) 637-5271 · **Fax:** (269) 639-2818
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 190 clinicians in 17 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (38), Nurse Practitioner (30), Internal Medicine (20); 12 practice at this address and 26 within 10 miles; [full list](https://npiprofile.com/npi/1174749170/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 27, 2023
- **Other identifiers:** Other 700H06003 (MI); Other 800020 (MI)
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1174749170) · Data from the CMS NPPES public registry.