Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Nicholas L Hartog, MD

Individual provider Allergy & Immunology Physician · NPI 1669766325

Dr. Nicholas L Hartog, MD is an Allergy/Immunology in Grand Rapids, Michigan. Graduated from Medical College of Wisconsin in 2011, 15 years ago. Practices with Spectrum Health Primary Care Partners, a 2,303-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Iowa, Michigan and Missouri.

Years since qualifying
15
Trained at
Medical College of Wisconsin
Licensed in
IA, MI, MO
In the registry since
2011
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3271 Clear Vista Ct NE
Grand Rapids, MI 49525-9477
Phone: (616) 267-7125
Fax: (616) 267-9593
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Allergy & Immunology Physician (primary) Taxonomy 207K00000X · Licence 4301108955 (MI)
Allergy & Immunology Physician Taxonomy 207K00000X · Licence 2014010402 (MO)
Internal Medicine Physician Taxonomy 207R00000X · Licence R-9168 (IA)

Record details

NPI number1669766325
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 30, 2011
Last updated in NPPESMarch 17, 2021
Certification dateMarch 17, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyALLERGY/IMMUNOLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2011 (15 years in practice)
Group practice Spectrum Health Primary Care Partners — 2303 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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