DR. MADELON K. KRISSOFF


Address: 233 E. Fulton, Suite #102, Grand Rapids, MI 49503
Phone: 6167442588

DR. MADELON K. KRISSOFF (NPI# 1134340003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1134340003
Entity Type Individual
Full Name DR. MADELON K. KRISSOFF
Credential MD
Practice Address 233 E. Fulton
Suite #102
Grand Rapids
MI 49503
Mailing Address 515 Lakeside Drive Se
Suite 103
East Grand Rapids
MI 49506
Practice Telephone 6167442588
Practice Fax Number 6167446839
Mailing Telephone 6167742588
Mailing Fax Number 6167746839
Enumeration Date 2007-05-01
Last Update Date 2014-08-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RG0300X Internal Medicine
Specialization: Geriatric Medicine
4301406025 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI 4116499 05

Office Location

Street Address 233 E. FULTON
SUITE #102
City GRAND RAPIDS
State MI
Zip Code 49503

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1194368647 Amy Jo Arends Nurse Practitioner 350 Lafayette S.e., Suite 301, Grand Rapids, MI 49503 2019-10-28
1376185199 Beth Arce Occupational Therapist 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 2019-10-14
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Taxonomy Information

Taxonomy Code 207RG0300X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Geriatric Medicine

Taxonomy Definition

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457661597 Spectrum Health Primary Care Partners Internal Medicine 1049 E Paris Ave Se, Grand Rapids, MI 49546-8336 2010-10-07
1447586540 Michigan Medical Patient Care Internal Medicine 6117 Charlevoix Woods Ct Se, Grand Rapids, MI 49546-8505 2009-10-23
1467693838 Michigan Medical Patient Care Internal Medicine 1049 East Paris Ave Se, Grand Rapids, MI 49546-8336 2009-03-16
1477521094 Clinton J Harris, Md, Plc Internal Medicine 3600 E Fulton St, Grand Rapids, MI 49546-1322 2006-03-09
1982976247 Ishrat Jahan Internal Medicine 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 2012-02-02
1669782132 Spectrum Health Primary Care Partners Internal Medicine 6117 Charlevoix Woods Ct Se, Grand Rapids, MI 49546 2010-10-18
1043251275 Kathleen Mosentine Internal Medicine 100 Michigan St Ne, Suite A721, Grand Rapids, MI 49503-2560 2006-06-09

Providers in the same taxonomy and state

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1801371315 Matrix Medical Pllc Internal Medicine 52611 Blueridge Dr, Shelby Twp, MI 48316-2977 2018-10-01
1407364821 Chesaning Comfort Care Internal Medicine 1800 W Brady Rd, Chesaning, MI 48616 2018-01-19
1992252191 Vitality Home Health Services,inc. Internal Medicine 917 W Milham Ave, Portage, MI 49024-1248 2016-09-06
1427419662 Shoaib A Rasheed Internal Medicine 250 Mcdougall St, Detroit, MI 48207-4291 2016-03-16
1710226477 Nancy Couch Internal Medicine 791 Bradburn Ct, Northville, MI 48167-1027 2013-01-31
1639425879 Anhkiet L Tran Internal Medicine 29736 Orion Ct, Farmington Hills, MI 48334-4114 2012-07-25
1700152014 Nicholas Joseph Internal Medicine 24463 W 10 Mile Rd, Pace Southeast Michigan, Southfield, MI 48033-2931 2012-03-30
1689949034 Drs Housecalls PC Internal Medicine 298 S. Old Woodward, Birminham, MI 48009 2012-03-19
1699055269 Mobilized Docs of Michigan LLC Internal Medicine 23943 Industrial Park Dr, Farmington Hills, MI 48335-2862 2011-08-26
1780986018 Spectrum Health Primary Care Partners Internal Medicine 727 Apple Ave, Holland, MI 49423-5405 2010-11-18
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City GRAND RAPIDS
Zip Code 49503

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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