DR. NICHOLAS L HARTOG M.D.
NPI 1669766325
Allergy & Immunology in Grand Rapids, MI

Q: What is Nicholas Hartog's NPI number?

The NPI number for Nicholas Hartog is 1669766325. It was assigned to this individual provider in the NPPES registry on May 30, 2011.

Q: What is Nicholas Hartog's specialty?

The primary specialty registered for this NPI is Allergy & Immunology with taxonomy code 207K00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Hartog was last updated on March 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since May 30, 2011PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

3271 CLEAR VISTA CT NE, GRAND RAPIDS, MI 49525(616) 267-7125(616) 267-9593 Get Directions Write a Review

NPPES record last updated: March 17, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 17, 2021, Aug 15, 2016 (2 updates tracked since 2016).

On this page

About Dr. Nicholas L Hartog M.d. NPPES

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

DR. NICHOLAS L HARTOG M.D. (NPI 1669766325) is an individual allergy & immunology provider in Grand Rapids, Michigan, licensed in Michigan (4301108955) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Medical College Of Wisconsin (2011).

NPPES Registry Identity

NPI1669766325

Entity TypeIndividualMale

Primary Taxonomy207K00000X

Provider Legal NameDR. NICHOLAS L HARTOGCredential: M.D.

Location Address3271 CLEAR VISTA CT NEGrand Rapids, MI 49525-9477

Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560

Phone(616) 267-7125

Fax(616) 267-9593

Sole ProprietorNo

Medical School CMSMedical College Of WisconsinGraduated 2011

Enumeration DateMay 30, 2011

Last NPPES UpdateMarch 17, 20212 updates tracked since enumeration

NPPES CertifiedMarch 17, 2021

✔ NPI 1669766325 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAllergy & ImmunologyAllopathic & Osteopathic Physicians

Taxonomy Code207K00000X

Licenses✔ Licensed in MI · 4301108955✔ Licensed in MO · 2014010402

Definition

An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system.

Also ListedInternal MedicineTaxonomy 207R00000X · License R-9168 (IA)

3271 CLEAR VISTA CT NE, Grand Rapids, MI 49525

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nicholas L Hartog 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 ID4284860073

PECOS Enrollment IDI20160712000142

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.

Medicare Billing Reassignment

Medicare enrollment records show Nicholas Hartog reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Spectrum Health Primary Care Partners

Same address

Nurse Practitioner

3271 CLEAR VISTA CT NE
Grand Rapids, MI 49525

Reassigned Medicare billing, Michigan enrollment
2,446 clinicians in this Medicare group

NPI 1346480258 (616) 391-7800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

39 services28 patients

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.

18 services16 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

12 services12 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230038

Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County

Emergency services Birthing friendly

Corewell Health Ludington Hospital

Acute Care Hospitals · Ludington, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230110

LocationOne N Atkinson DriveLudington, MI 49431 · Mason County

Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

87.54

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 5

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

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221

DME-Other DME · category DE017N

5 suppliers57 claims198 services$18.49 avg. paid by Medicare

Injection, immune globulin (cuvitru), 100 mg J1555

Treatment-Injections and Infusions (nononcologic) · category RI008N

6 suppliers53 claims24,614 services$11.72 avg. paid by Medicare

Injection, immune globulin (hizentra), 100 mg J1559

Treatment-Injections and Infusions (nononcologic) · category RI008N

3 suppliers33 claims16,080 services$9.47 avg. paid by Medicare

Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg J1561

Treatment-Injections and Infusions (nononcologic) · category RI008N

1 supplier11 claims660 services$34.89 avg. paid by Medicare

Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each K0552

DME-Other DME · category DE000N

5 suppliers68 claims330 services$2.38 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.

DR. JOHN E. HESLIP M.D.

Internal Medicine

3271 CLEAR VISTA CT NE, SUMMIT PARK CENTER-INTERNAL MED & PEDS
GRAND RAPIDS, MI 49525

Kent County (616) 391-7800

DR. COURTNEY COTTER DO

Allergy & Immunology