Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Stefano John Bordoli, MD

Individual provider Surgery Physician · NPI 1760648364

Dr. Stefano John Bordoli, MD is a Vascular Surgery in Grand Rapids, Michigan. Qualified in 2006, 20 years ago. Practices with Spectrum Health Primary Care Partners, a 2,303-clinician group and accepts Medicare assignment. Licensed in Illinois and South Carolina.

Years since qualifying
20
Licensed in
IL, SC
In the registry since
2008
Specialties on file
2
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

275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone: (616) 267-8700
Fax: (616) 267-8247
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence LL 33480 (SC)
Surgery Physician Taxonomy 208600000X · Licence 125051812 (IL)

Record details

NPI number1760648364
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 3, 2008
Last updated in NPPESJanuary 27, 2025
Certification dateJanuary 27, 2025

Medicare enrollment

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

Medicare specialtyVASCULAR SURGERY
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Spectrum Health Primary Care Partners — 2303 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations14 on file with Medicare

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