Trinity Health Medical Group – Internal Medicine Physician, NPI 1629010384
Internal Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Trinity Health Medical Group
6401 Prairie St Ste 2300
Norton Shores, MI 494447842
Phone: (231) 727-7928
Fax: (231) 727-7844
Type: Location
1500 E Sherman Blvd
Muskegon, MI 494441849
Phone: (231) 672-3883
Type: Location
1310 Wisconsin St Ste 200
Grand Haven, MI 494172472
Phone: (616) 844-4790
Fax: (616) 844-4794
Type: Location
US Post Office - North Muskegon, 404, Center Street, North Muskegon, Muskegon County, Michigan, 49445, United States
MUSKEGON, MI 494431847
Phone: (231) 672-2120
Fax: (231) 728-5981
Type: Mailing
PO BOX 776982
CHICAGO, IL 606776982
Phone: (800) 494-5797
Type: Mailing
2400, East Sherman Boulevard, Muskegon, Muskegon County, Michigan, 49444, United States
MUSKEGON, MI 49444
Phone: (231) 672-6336
Fax: (231) 672-6335
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-08-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040429000064 | O | Clinic/Group Practice | MI | TBD |
| O20040804001335 | O | Clinic/Group Practice | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49444)
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