NPIMap

Individual provider Active NPI

Charles Trevor Crellin, M.D.

  • Orthopaedic Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1053773507
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301110371 Issued in MI
Practice address
2770 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Phone
(616) 267-8860
NPI assigned
Mar 23, 2016
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4301110371 MI Primary

Addresses

Primary practice location

2770 E Beltline Ave NE
Grand Rapids, MI 49525-8614

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
Direct Messaging Address mkoets121607@epic00.shdirect.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211004149 MI Practitioner - Orthopedic Surgery 0648563981 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of North Dakota School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health UnitedGroup PAC ID 6305836487, 90 clinicians

Practice addresses (Care Compare)

1009 W Green St
Corewell Health Medical Group West
Hastings, MI 49058-1710
Phone (269) 945-1212

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

2750 E Beltline Ave NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-8614
Phone (616) 267-8950

2750 E Beltline Ave NE FL
Grand Rapids, MI 49525-8614

2770 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Phone (616) 267-8860

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

615 S Bower St
Greenville, MI 48838-2614
Phone (616) 225-6522

707 S Greenville W Dr
Greenville, MI 48838-3514
Phone (616) 225-6477

9090 S Rodgers CT SE a
Corewell Health Medical Group West
Caledonia, MI 49316-8052
Phone (616) 891-0422

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement17
Knee replacement12
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301110371MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health United CurrentSince Sep 29, 2025 Accepting new patients
Ortho Montana, PSC Orthopaedic Surgery CurrentSince Sep 6, 2022 Accepting new patients
Spectrum Health Primary Care Partners Orthopaedic Surgery CurrentSince Jan 28, 2025 Accepting new patients
Spectrum Health United CurrentSince Sep 29, 2025 Accepting new patients
Pennock Hospital CurrentSince Jan 28, 2025 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 28, 2025 Accepting new patients
Pennock Hospital CurrentSince Jan 28, 2025 Accepting new patients
Ortho Montana, PSC Orthopaedic Surgery CurrentSince Sep 6, 2022 Accepting new patients
Spectrum Health United Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1227 W State St
Belding, MI 48809
Phone (616) 794-0800

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

221 Michigan St NE
Fl 4
Grand Rapids, MI 49503

2770 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-8860

1005 W Green St
Ste 300
Hastings, MI 49058
Phone (269) 948-8411

840 Cook Rd
Hastings, MI 49058
Phone (269) 945-4966

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

1739 Spring Creek Rd
Billings, MT 59102
Phone (406) 237-5050

2900 12th Ave N
Ste 140W
Billings, MT 59101
Phone (406) 237-5050

Organizations & group practices 10

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 6

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": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1053773507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495258614",
            "telephone_number": "616-267-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRELLIN",
        "first_name": "CHARLES",
        "middle_name": "TREVOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301110371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "2770 E Beltline Ave NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495258614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkoets121607@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "2770 E Beltline Ave NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495258614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.