WEST MICHIGAN EAR, NOSE AND THROAT
NPI 1942669296
Otolaryngology in Portage, MI

Active since February 15, 2016
3850 GLENKERRY CT, PORTAGE, MI 49024(269) 327-7200(269) 327-9272 Get Directions Write a Review

NPPES record last updated: July 22, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 22, 2024, Feb 15, 2016 (2 updates tracked since 2016).

  • Organization
  • Otolaryngology
  • Accepts Insurance

About WEST MICHIGAN EAR, NOSE AND THROAT

This page provides the complete NPI Profile along with additional information for West Michigan Ear, Nose And Throat, a provider established in Portage, Michigan operating as a Otolaryngology. The healthcare provider is registered in the NPI registry with number 1942669296 assigned on February 2016. The practitioner's primary taxonomy code is 207Y00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. West Michigan Ear, Nose And Throat operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as West Michigan Ear, Nose And Throat. The authorized official of this NPI record is Jeffery Costello (Cfo)

NPI
1942669296 Verify this NPI
Provider Legal Name
THREE RIVERS HEALTH SYSTEM, INC
Other Organization Name
WEST MICHIGAN EAR, NOSE AND THROAT
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3850 GLENKERRY CT PORTAGE, MI 49024
Location Phone
(269) 327-7200
Location Fax
(269) 327-9272
Mailing Address
3245 HEALTH DR STE 100 GRANGER, IN 46530
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
02-15-2016
Last Update Date
07-22-2024
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Otolaryngology

Taxonomy Code
207Y00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207YX0905XAllopathic & Osteopathic Physicians

Otolaryngology
Otolaryngology/Facial Plastic Surgery

 

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JEFFERY COSTELLO

Authorized Official Title
CFO
Authorized Official Phone
(574) 647-3460

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1942669296MEDICAID (05)MI 

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Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Otolaryngology
3850 GLENKERRY CT
PORTAGE, MI 49024
Physician Assistant
3850 GLENKERRY CT
PORTAGE, MI 49024
Otolaryngology
3850 GLENKERRY CT
PORTAGE, MI 49024
Clinic/Center
3850 GLENKERRY CT
PORTAGE, MI 49024
Audiologist
3850 GLENKERRY CT
PORTAGE, MI 49024
Audiologist
3850 GLENKERRY CT
PORTAGE, MI 49024
Physician Assistant
3850 GLENKERRY CT
PORTAGE, MI 49024

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1942669296, enumerated as an "organization" on February 15, 2016.

The provider is located at 3850 GLENKERRY CT PORTAGE, MI 49024 and the phone number is (269) 327-7200.

Otolaryngology with taxonomy code 207Y00000X.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.