DR. MARC HEADAPOHL M.D.
NPI 1033158159
Emergency Medicine - Emergency Medical Services in Kalamazoo, MI


Quality Rating: 98.33 out of 100 score

NPI Status: Active since June 05, 2006

Contact Information

1850 WHITES RD
SUITE 3
KALAMAZOO, MI
ZIP 49008
Phone: (269) 343-3900
Fax: (269) 343-5640

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  • Individual
  • Male
  • Years of Experience 31
  • Emergency Medicine
  • Emergency Medical Services
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About MARC HEADAPOHL

This page provides the complete NPI Profile along with additional information for Marc Headapohl, a provider established in Kalamazoo, Michigan with a medical specialization in Emergency Medicine, focusing in emergency medical services and more than 31 years of experience. He graduated from University Of Michigan Medical School in 1995. The healthcare provider is registered in the NPI registry with number 1033158159 assigned on June 2006. The practitioner's primary taxonomy code is 207PE0004X with license number 4301074898 (MI). The provider is registered as an individual and his NPI record was last updated 18 years ago.

NPI
1033158159
Provider Name
DR. MARC HEADAPOHL M.D.
Gender
Male
Entity Type
Individual
Location Address
1850 WHITES RD SUITE 3 KALAMAZOO, MI 49008
Location Phone
(269) 343-3900
Location Fax
(269) 343-5640
Mailing Address
1850 WHITES RD SUITE 3 KALAMAZOO, MI 49008
Mailing Phone
(269) 343-3900
Mailing Fax
(269) 343-5640
Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduation Year
1995
Is Sole Proprietor?
Yes
Enumeration Date
06-05-2006
Last Update Date
07-08-2007
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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

Emergency Medicine Emergency Medical Services

Taxonomy Code
207PE0004X
Type
Allopathic & Osteopathic Physicians
License No.
4301074898
License State
MI
Taxonomy Description
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.

Insurance Plans Accepted

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

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

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.

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
G91181MEDICARE UPIN (02)MI 
OC96159058MEDICARE ID-TYPE UNSPECIFIED (04)MI 

Medicare Participation & PECOS Enrollment Status

Marc Headapohl is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Marc Headapohl is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3678522703

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20050115000107

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Critical care, first 30-74 minutes

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

This service was performed 28 times for 28 patients

Emergency department visit for life threatening or functioning severity

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

This service was performed 283 times for 271 patients

Emergency department visit for problem of high severity

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

This service was performed 84 times for 67 patients

Emergency department visit for problem of moderate severity

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

This service was performed 26 times for 26 patients

Initial hospital observation care per day, typically 70 minutes

This service involves a healthcare professional closely monitoring your health condition during your hospital stay. It typically lasts for about 70 minutes each day. This helps in timely detection of any changes in your health, allowing for immediate response and treatment.

This service was performed 24 times for 24 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.18 for a new patient copayment and $24.11 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 49008 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.74
  • Minimum New Patient Price $54.34
  • Maximum New Patient Price $166.68
  • Average New Patient Copayment $21.18
  • Minimum New Patient Copayment $13.58
  • Maximum New Patient Copayment $41.67

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $96.44
  • Minimum Established Patient Price $17.09
  • Maximum Established Patient Price $135.4
  • Average Established Patient Copayment $24.11
  • Minimum Established Patient Copayment $4.27
  • Maximum Established Patient Copayment $33.85

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 98.33, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 98.33 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 82.88

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Implementation of an ASPYesN/A
Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance
Implementation of formal quality improvement methods, practice changes, or other practice improvement processesYesN/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Participation in an AHRQ-listed patient safety organization.YesN/A
Participation in an AHRQ-listed patient safety organization.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Marc Headapohl is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
LAKELAND HOSPITAL, ST JOSEPH1234 NAPIER AVENUE
ST JOSEPH, MI 49085
(269) 983-8300Acute Care Hospitals
COREWELL HEALTH WATERVLIET HOSPITAL400 MEDICAL PARK DR
WATERVLIET, MI 49098
(269) 463-3111Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1033158159
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
20632516110
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 6 + 3 + 2 + 5 + 1 + 6 + 1 + 1 + 0 + 24 = 51
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 51 = 99

The NPI number 1033158159 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 17 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1578522173 ZBIGNIEW MARK SRODULSKI M.D.
Individual
Emergency Medicine1850 WHITES RD SUITE 3
KALAMAZOO, MI 49008
(269) 343-3900
1821051822DR. LISA WAGNER FORREST MD
Individual
Emergency Medicine1850 WHITES RD
KALAMAZOO, MI 49008
(269) 343-3900
1114984127DR. BETH JOY ARMSTRONG M.D.
Individual
Emergency Medicine1850 WHITES RD SUITE 3
KALAMAZOO, MI 49008
(269) 343-3900
1770590960DR. JEFFREY N HAMLIN D.M.D
Individual
Dentist (Oral and Maxillofacial Surgery)1850 WHITES RD SUITE 2
KALAMAZOO, MI 49008
(269) 385-2101
1053483826 PHILLIP THOMAS DOYLE DDS MS
Individual
Dentist (Periodontics)1850 WHITES RD
KALAMAZOO, MI 49008
(269) 381-3212
1578613162DR. RICHARD D SEABOLD DDS, MS
Individual
Dentist (Orthodontics and Dentofacial Orthopedics)1850 WHITES RD SUITE #1
KALAMAZOO, MI 49008
(269) 345-5141
1336292978DR. VERLE HOWARD WIITA DDS
Individual
Dentist (General Practice)1850 WHITES RD SUITE 8
KALAMAZOO, MI 49008
(269) 383-0101
1588710826DR. KENNETH W BEADLING JR. DDS
Individual
Dentist1850 WHITES RD SUITE #4
KALAMAZOO, MI 49008
(269) 381-2587
1235269291DR. JAMES J BRAYTON D.D.S.,M.S.,P.C.
Individual
Dentist (Periodontics)1850 WHITES RD SUITE 6
KALAMAZOO, MI 49008
(269) 382-3961
1912039892DR. DANIEL L BOUWMAN MD
Individual
Preventive Medicine (Preventive Medicine/Occupational Environmental Medicine)1850 WHITES RD SUITE 3
KALAMAZOO, MI 49008
(269) 343-3900
1013114693DR. BRANNON CHARLES DUNCAN M.D.
Individual
Emergency Medicine1850 WHITES RD SUITE 3
KALAMAZOO, MI 49008
(269) 343-3900
1285885459JEFFREY N HAMLIN DMD PC
Organization
Dentist (Oral and Maxillofacial Surgery)1850 WHITES RD SUITE 2
KALAMAZOO, MI 49008
(269) 385-2101
1356586697STEVEN B RAY DMD PC
Organization
Dentist1850 WHITES RD SUITE 7
KALAMAZOO, MI 49008
(269) 342-5321
1972800522PHILLIP T. DOYLE DDS PC
Organization
Dentist (Periodontics)1850 WHITES RD
KALAMAZOO, MI 49008
(269) 381-3212
1174710404 MATTHEW JV WILTON PA-C
Individual
Physician Assistant (Medical)1850 WHITES RD SUITE 3
KALAMAZOO, MI 49008
(269) 343-3900
1174182356 KEVIN MALERMAN
Individual
Dentist1850 WHITES RD
KALAMAZOO, MI 49008
(269) 342-5321
1821186883CHAD SEABOLD, D.D.S., M.D., P.L.C.
Organization
Clinic/Center1850 WHITES RD SUITE 1
KALAMAZOO, MI 49008
(269) 343-4789

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1033158159, enumerated in the NPI registry as an "individual" on June 05, 2006

The provider is located at 1850 Whites Rd Suite 3 Kalamazoo, Mi 49008 and the phone number is (269) 343-3900

The provider's speciality is Emergency Medicine with taxonomy code 207PE0004X with a focus in Emergency Medical Services

The provider has more than 31 years of experience. He graduated from University Of Michigan Medical School in 1995.

The provider might be accepting Accepts: Ambetter from Meridian, Ambetter Health, Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $84.74 with an average copayment of $21.18 for new patient appointments. Established patients should expect a typical charge of $96.44 and an average copayment of 24.11. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Critical care, first 30-74 minutes, Emergency department visit for life threatening or functioning severity, Emergency department visit for problem of high severity, Emergency department visit for problem of moderate severity and Initial hospital observation care per day, typically 70 minutes.

The practitioner is affiliated to the following hospital(s): LAKELAND HOSPITAL, ST JOSEPH and COREWELL HEALTH WATERVLIET HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 05, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.