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INTERNAL MEDICINE OF WEST MICHIGAN PLLC
NPI 1619028412
Internal Medicine in Grand Rapids, MI

Active since January 16, 2007CLIA 23D1015125 · Waiver
3200 EAGLE PARK DR NE, SUITE 102, GRAND RAPIDS, MI 49525(616) 285-9090(616) 285-7947 Get Directions Write a Review

NPPES record last updated: October 25, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Internal Medicine Of West Michigan Pllc NPPES

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

INTERNAL MEDICINE OF WEST MICHIGAN PLLC (NPI 1619028412), doing business as Dr's Marvin, Gans And Roslaniec, is a healthcare organization registered as an internal medicine in Grand Rapids, Michigan and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through July 23, 2027 and lists Elizabeth A Kozak, Partner, as its authorized official.

NPPES Registry Identity

NPI1619028412
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameINTERNAL MEDICINE OF WEST MICHIGAN PLLC
Location Address3200 EAGLE PARK DR NE, SUITE 102Grand Rapids, MI 49525-7057
Mailing Address3200 Eagle Park Dr Ne, Suite 102Grand Rapids, MI 49525-7057 · (616) 285-9090 · Fax (616) 285-7947
Phone(616) 285-9090
Fax(616) 285-7947
Organization SubpartNo
Authorized OfficialElizabeth A KozakPartner · (616) 285-9090
Enumeration DateJanuary 16, 2007
Last NPPES UpdateOctober 25, 2024
NPPES CertifiedOctober 25, 2024
✔ NPI 1619028412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
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.
3200 EAGLE PARK DR NE, Grand Rapids, MI 49525
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Other Names 1

Former Legal Business NameDr's Marvin, Gans And Roslaniec

Other Identifiers 1

OtherG02811MI · Blue Cross Group Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Internal Medicine Of West Michigan Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Internal Medicine Of West Michigan PLLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Brooke Lenz, DO
Family Practice
NPI 1053995522
3200 EAGLE PARK DR NE STE 102
Grand Rapids, MI 49525
(616) 285-9090
✔ PECOS✔ Accepts MedicareSame address
David Listello, M.D.
Pulmonary Disease
NPI 1508973538
3200 EAGLE PARK DR NE STE 102
Grand Rapids, MI 49525
(616) 285-9090
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Kozak, M.D.
Internal Medicine
NPI 1811076805
3200 EAGLE PARK DR NE SUITE 102
Grand Rapids, MI 49525
(616) 285-9090
✔ PECOS✔ Accepts MedicareSame address
Andrew Izzo, DO
Family Practice
NPI 1639699481
3200 EAGLE PARK DR NE STE 102
Grand Rapids, MI 49525
(616) 285-9090
✔ PECOS✔ Accepts MedicareSame address
Danielle Strunk, MD
Internal Medicine
NPI 1336776566
4069 LAKE DR SE STE 315
Grand Rapids, MI 49546
(616) 267-7700
✔ PECOS✔ Accepts Medicare3.5 mi
Christopher Davis, D.O.
Family Practice
NPI 1205276383
2550 W MAIN ST
Lowell, MI 49331
(616) 252-5600
✔ PECOS✔ Accepts Medicare12 mi
Nikunj Patel, MD
Family Practice
NPI 1083348528
295 WHARTON LN NE
Norton, VA 24273
(276) 679-0321
✔ PECOS✔ Accepts Medicare446 mi

Source: 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

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 Waiver 23D1015125

Internal Medicine Of West Michigan, PLLC · Grand Rapids, MI
Active · expires Jul 23, 2027
CLIA Number23D1015125
Laboratory TypePhysician Office
Certificate Effective DateJuly 24, 2025
Certificate Expiration DateJuly 23, 2027
Laboratory DirectorElizabeth A. Kozak
Laboratory Phone(616) 285-9090
Laboratory LocationInternal Medicine Of West Michigan, PLLC3200 Eagle Park Drive, NE Suite 102, Grand Rapids, MI 49525
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Internal Medicine Of West Michigan PLLC's NPI number?

The NPI number for Internal Medicine Of West Michigan PLLC is 1619028412. It was assigned to this organization in the NPPES registry on January 16, 2007. The provider was formerly known as Dr's Marvin, Gans And Roslaniec.

Where is Internal Medicine Of West Michigan PLLC located?

Internal Medicine Of West Michigan PLLC is located at 3200 Eagle Park Dr NE Suite 102, Grand Rapids, MI 49525. The listed phone number is (616) 285-9090.

What is Internal Medicine Of West Michigan PLLC's specialty?

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

Is Internal Medicine Of West Michigan PLLC enrolled in Medicare?

Yes. Internal Medicine Of West Michigan PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Internal Medicine Of West Michigan PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Internal Medicine Of West Michigan PLLC. 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 Family Practice (4), Internal Medicine (2) and Pulmonary Disease (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Internal Medicine Of West Michigan PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1015125) is associated with this NPI, valid through July 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Internal Medicine Of West Michigan PLLC accept?

Health plans from Blue Care Network of Michigan list Internal Medicine Of West Michigan PLLC 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 Internal Medicine Of West Michigan PLLC was last updated on October 25, 2024. 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.