Individual provider Active NPI

Benjamin Carroll Grant, PA-C

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1114348737
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006899 Issued in MI
Practice address
100 Michigan St NE Ste 8861
Grand Rapids, MI 49503-2560
Phone
(616) 391-6588
NPI assigned
Dec 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601006899 MI Primary

Addresses

Primary practice location

100 Michigan St NE Ste 8861
Grand Rapids, MI 49503-2560

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Other names 1

  • Roman Benjamin Carroll Grant Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bgrant89188@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140226001688 MI Practitioner - Physician Assistant 4385874957 Reassigns benefits to 1 organization
I20230425002843 AR Practitioner - Physician Assistant 4385874957 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

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

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jun 23, 2025 Accepting new patients
Arkansas Childrens Hospital CurrentSince Jan 21, 2025 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 1, 2023 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Apr 1, 2023 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jan 21, 2025 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jun 23, 2025 Accepting new patients

Locations

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

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

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

100 Michigan St NE
#19
Grand Rapids, MI 49503
Phone (616) 391-1969

100 Michigan St NE
Ste 8861
Grand Rapids, MI 49503
Phone (616) 391-2802

25 Michigan St NE
Ste 6100
Grand Rapids, MI 49503
Phone (616) 267-7900

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

Organizations & group practices 9

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 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": "1388102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1114348737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE STE 8861",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "BENJAMIN",
        "middle_name": "CARROLL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-27",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bgrant89188@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "100 Michigan St NE Ste 8861",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "100 Michigan St NE Ste 8861",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ROMAN",
            "last_name": "GRANT",
            "middle_name": "BENJAMIN CARROLL",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.