Individual provider Active NPI

Paul D Harris, DO

  • Pulmonary Disease Physician
  • Grand Rapids, MI
National Provider Identifier
1033144266
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
5101012300 Issued in MI
Practice address
310 Lafayette Ave SE
Ste 415
Grand Rapids, MI 49503-4693
Phone
(616) 685-5666
NPI assigned
Jul 12, 2006
Last updated
Jul 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101012300 MI
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 5101012300 MI
Pulmonary Disease Physician 207RP1001X 5101012300 MI Primary

Addresses

Primary practice location

310 Lafayette Ave SE
Ste 415
Grand Rapids, MI 49503-4693

Mailing address

245 State St SE
Ste 228
Grand Rapids, MI 49503-4328

Other identifiers 2

IdentifierTypeStateIssuer
4306439MedicaidMI
4877939MedicaidMI

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
I20060918000312 MI Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 6406851898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine, Pulmonary Disease
Education
Michigan State University College of Osteopathic Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

310 Lafayette Ave SE
Suite 415
Grand Rapids, MI 49503-4693
Phone (616) 685-5666

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Aug 1, 2013 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince Aug 1, 2013 Accepting new patients
Metropolitan Hospital Internal Medicine CurrentSince Oct 20, 2008 Accepting new patients
Trinity Health - Michigan Past Accepting new patients
Saint Mary's Health Services Past Accepting new patients
Advantage Health Saint Mary's Medical Group Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

245 State St SE
Ste 1A
Grand Rapids, MI 49503

200 Jefferson Ave SE
Grand Rapids, MI 49503
Phone (616) 685-5000

245 State St SE
Ste 228
Grand Rapids, MI 49503

310 Lafayette Ave SE
Ste 415
Grand Rapids, MI 49503
Phone (616) 685-5666

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

Interoperability endpoints

  • Direct secure messaging: pharris40688@direct.trinity-health.org

Organizations & group practices 7

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

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1033144266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 STATE ST SE",
            "address_2": "STE 228",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 LAFAYETTE AVE SE",
            "address_2": "STE 415",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034693",
            "telephone_number": "616-685-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "PAUL",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101012300",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "5101012300",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "5101012300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4306439",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4877939",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.