Individual provider Active NPI

Dylan M Meyer, RN, BSN

  • Certified Registered Nurse Anesthetist
  • Grand Rapids, MI
National Provider Identifier
1003455981
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704310592 Issued in MI
Practice address
1085 Kentwood St NE
Grand Rapids, MI 49505-4837
Phone
(616) 308-7915
NPI assigned
Dec 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X M149864 MI
Certified Registered Nurse Anesthetist 367500000X 4704310592 MI Primary

Addresses

Primary practice location

1085 Kentwood St NE
Grand Rapids, MI 49505-4837

Mailing address

1085 Kentwood St NE
Grand Rapids, MI 49505-4837
Phone (616) 308-7915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201117002158 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709297005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Michigan II PCGroup PAC ID 7911895164, 22 clinicians

Practice addresses (Care Compare)

212 S Sullivan Ave
Fremont, MI 49412-1548
Phone (231) 924-3300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Certified Registered Nurse, Registered Nurse

State licenses

LicenseStateTypeSpecialty
M149864MIMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered CurrentSince Jul 31, 2020 Accepting new patients

Locations

2075 Coolidge Rd
East Lansing, MI 48823
Phone (517) 319-9000

212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212

1707 Lake Lansing Rd
Lansing, MI 48912
Phone (517) 267-0033

3400 E Jolly Rd
Lansing, MI 48910
Phone (517) 272-1063

26750 Providence Pkwy
Ste 100
Novi, MI 48374
Phone (248) 662-1500

Organizations & group practices 1

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": "1577232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1003455981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 KENTWOOD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054837",
            "telephone_number": "616-308-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 KENTWOOD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054837",
            "telephone_number": "616-308-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "DYLAN",
        "middle_name": "M",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-25",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MI",
            "license": "M149864",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704310592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.