Individual provider Active NPI

Thomas Ryan Birris, MD

  • Gastroenterology Physician
  • Saint Joseph, MI
National Provider Identifier
1003083627
Registry record updated May 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301100025 Issued in MI
Practice address
3903 Hollywood Rd
Saint Joseph, MI 49085-9149
Phone
(269) 408-1100
NPI assigned
May 13, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036120897 IL
Gastroenterology Physician 207RG0100X 4301100025 MI Primary

Addresses

Primary practice location

3903 Hollywood Rd
Saint Joseph, MI 49085-9149

Mailing address

3903 Hollywood Rd
Saint Joseph, MI 49085-9149

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120711000532 MI Practitioner - Internal MedicinePractitioner - Gastroenterology 9537324884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 983-8300

3950 Hollywood Rd
Saint Joseph, MI 49085-9151

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy37
Upper gastrointestinal (GI) endoscopy for acid reflux102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036120897ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices Internal Medicine CurrentSince Jul 16, 2012 Accepting new patients
Lakeland Medical Practices Internal Medicine CurrentSince Jul 16, 2012 Accepting new patients

Locations

42 N Saint Joseph Ave
Ste 301
Niles, MI 49120
Phone (269) 428-0002

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

3903 Hollywood Rd
Saint Joseph, MI 49085
Phone (269) 408-1100

Interoperability endpoints

  • Direct secure messaging: tbirris1268549@epic00.shdirect.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1003083627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 HOLLYWOOD RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 HOLLYWOOD RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859149",
            "telephone_number": "269-408-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRRIS",
        "first_name": "THOMAS",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036120897",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301100025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.