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SARA CUSTODIO M.D.
NPI 1417162173
Internal Medicine in Kalamazoo, MI

Active since May 14, 2007PECOS EnrolledAccepts Medicare Assignment
5629 STADIUM DR, SUITE B, KALAMAZOO, MI 49009(269) 544-3270 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sara Custodio M.d. NPPES

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

SARA CUSTODIO M.D. (NPI 1417162173) is an individual internal medicine provider in Kalamazoo, Michigan, licensed in Michigan (4301085859) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS, is affiliated with Bronson Methodist Hospital, and is a graduate of Michigan State University College Of Human Medicine (2005).

NPPES Registry Identity

NPI1417162173
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameSARA CUSTODIOCredential: M.D.
Location Address5629 STADIUM DR, SUITE BKalamazoo, MI 49009-1952
Mailing Address5629 Stadium Dr, Suite BKalamazoo, MI 49009-1952 · (269) 544-3270 · Fax (269) 544-3288
Phone(269) 544-3270
Sole ProprietorNo
Medical School CMSMichigan State University College Of Human MedicineGraduated 2005
Enumeration DateMay 14, 2007
Last NPPES UpdateNovember 27, 2023
NPPES CertifiedOctober 2, 2020
✔ NPI 1417162173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 4301085859
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
5629 STADIUM DR, Kalamazoo, MI 49009
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Other Identifiers 2

Medicaid1417162173MI
Other0C910950MI · Bcbsm

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

Sara Custodio M.d. 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 ID8426124389
PECOS Enrollment IDI20080829000394
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.
144 services84 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.
70 services70 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.
43 services42 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
12 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Bronson Methodist Hospital

Acute Care Hospitals · Kalamazoo, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230017
Location601 John StreetKalamazoo, MI 49007 · Kalamazoo County
Emergency services Birthing friendly

Bronson Battle Creek Hospital

Acute Care Hospitals · Battle Creek, MI
4/5 CMS rating
OwnershipProprietary
CMS Certification Number230075
Location300 North AvenueBattle Creek, MI 49017 · Calhoun County
Emergency services Birthing friendly

Bronson Lakeview Hospital

Critical Access Hospitals · Paw Paw, MI
OwnershipVoluntary non-profit - Private
CMS Certification Number231332
Location408 Hazen StreetPaw Paw, MI 49079 · Van Buren County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49009 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
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

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

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
4 suppliers15 claims15 services$184.68 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 20

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

MS. CAROL ANN VANANTWERP PNP
Nurse Practitioner (Pediatrics)
5629 STADIUM DR
KALAMAZOO, MI 49009
Kalamazoo County (269) 372-1000
LISA A NAGLER MD
Pediatrics
5629 STADIUM DR, BRONSON RAMBLING ROAD PEDIATRICS
KALAMAZOO, MI 49009
Kalamazoo County (269) 371-1000
ALBERT A CABALA MD
Internal Medicine
5629 STADIUM DR, SUITE B
KALAMAZOO, MI 49009
Kalamazoo County (269) 544-3270
PADMA P REDDY MD
Pediatrics
5629 STADIUM DR, BRONSON RAMBLING ROAD PEDIATRICS
KALAMAZOO, MI 49009
Kalamazoo County (269) 371-1000
MAUREEN M DOBBIE NP
Nurse Practitioner
5629 STADIUM DR, STE B BRONSON INTERNAL MEDICINE OSHTEMO
KALAMAZOO, MI 49009
Kalamazoo County (269) 544-3276
TROY A GREEN PAC
Physician Assistant
5629 STADIUM DR
KALAMAZOO, MI 49009
Kalamazoo County (269) 372-5701
WILLIAM J VENEMA MD
Pediatrics
5629 STADIUM DR, BRONSON RAMBLING ROAD PEDIATRICS
KALAMAZOO, MI 49009
Kalamazoo County (269) 371-1000
LUIS G ORTIZ MD
Internal Medicine
5629 STADIUM DR, BRONSON INTERNAL MEDICINE - OSHTEMO STE B
KALAMAZOO, MI 49009
Kalamazoo County (269) 544-3276

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 Sara Custodio's NPI number?

The NPI number for Sara Custodio is 1417162173. It was assigned to this individual provider in the NPPES registry on May 14, 2007.

Where is Sara Custodio located?

Sara Custodio practices at 5629 Stadium Dr Suite B, Kalamazoo, MI 49009. The listed phone number is (269) 544-3270.

What is Sara Custodio's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Sara Custodio enrolled in Medicare?

Yes. Sara Custodio 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 Sara Custodio accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Sara Custodio 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 Sara Custodio affiliated with any hospitals?

According to CMS data, Sara Custodio is affiliated with Bronson Methodist Hospital, Bronson Battle Creek Hospital and Bronson Lakeview Hospital.

When was this NPI record last updated?

The NPPES record for Sara Custodio 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.