Individual provider Active NPI

Justin Pyle

  • Anesthesiology Physician
  • Grand Rapids, MI
National Provider Identifier
1093221319
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4704274524 Issued in MI
Practice address
200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone
(616) 685-5000
NPI assigned
Dec 22, 2017
Last updated
Oct 12, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4704274524 MI Primary

Addresses

Primary practice location

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502

Mailing address

2650 Pebble CT
Zeeland, MI 49464-8984

Other practice location 1

8333 Felch St
Zeeland, MI 49464-2608
Phone (616) 364-4200

Other practice location 2

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Phone (616) 364-4200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180426002575 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395009377 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Mary's Health ServicesGroup PAC ID 4981500436, 175 clinicians
West Michigan Anesthesia PCGroup PAC ID 1355243551, 69 clinicians

Practice addresses (Care Compare)

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (734) 263-2400

3333 Evergeen Dr NE
Grand Rapids, MI 49525-9493
Phone (616) 364-4200

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

8333 Felch St
Zeeland, MI 49464-2608

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.16 of 100Reported as group
Quality
95.73
Improvement activities
40
Cost
75.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Consultants, PC Single Specialty CurrentSince Oct 1, 2022 Accepting new patients
Kalamazoo Anesthesiology P C Single Specialty CurrentSince Sep 22, 2020 Accepting new patients

Locations

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

3333 Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 284-3132

4055 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 252-4410

900 Peeler St
Kalamazoo, MI 49008
Phone (269) 345-8618

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

8333 Felch St
Zeeland, MI 49464
Phone (616) 741-3790

Organizations & group practices 5

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 2

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": "1513900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1093221319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 PEBBLE CT",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494648984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-685-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8333 Felch St",
            "address_purpose": "LOCATION",
            "city": "Zeeland",
            "state": "MI",
            "postal_code": "494642608",
            "country_code": "US",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 Evergreen Dr NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495259493",
            "country_code": "US",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PYLE",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-22",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4704274524",
            "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 12, 2022; 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.