Ronald J Dirkse, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

032227 Issued in MI

Practice address

12978 James St.
Ste 10
Holland, MI 49424

Phone

(616) 399-7005

Fax

(616) 399-7150

NPI assigned

Jul 25, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 5, 2016 through Apr 5, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Comprehensive Psyiatric Services of Western Mi PC

  • Child & Adolescent Psychiatry Physician
  • Holland, MI
  • NPI 1013095454
  NPD (past) Authorized official

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1033374368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12978 JAMES ST.",
            "address_2": "STE 10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49424",
            "telephone_number": "616-399-7005",
            "fax_number": "616-399-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12978 JAMES ST.",
            "address_2": "STE 10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49424",
            "telephone_number": "616-399-7005",
            "fax_number": "616-399-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRKSE",
        "first_name": "RONALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-25",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "032227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wilford Anthony Dilbert
• Anthony Dils, MD
• Jennifer Dils, LBSW
• Erin Rebecca Dimmer, RN
• Kathleen Sue Dirkse, FNP
• Disability Network/ Lakeshore
• Roberta Jean Dischinger-Smedes, MSN, APRN, BC, FNP
• Brian Norbert Dishinger, MD
• Diverse Home Health Care
• Krzysztof Dlugosz, P.T.

• Child & Adolescent Psychiatry Physician in Holland, MI
• Providers in Holland, MI by specialty
• Child & Adolescent Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.