Individual provider Active NPI

Joanne Marie Grzeszak, DO

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1124083670
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101007147 Issued in MI
Practice address
806 Alger St SE
Grand Rapids, MI 49507-3803
Phone
(616) 252-7200
Fax
(616) 452-9247
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101007147 MI Primary

Addresses

Primary practice location

806 Alger St SE
Grand Rapids, MI 49507-3803

Mailing address

5900 Byron Center Ave SW
Attn: Medical Administration
Wyoming, MI 49519-9606
Phone (164) 528-9236

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
I20100115000055 MI Practitioner - General PracticePractitioner - Geriatric MedicinePractitioner - Family Practice 4284776113 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince Jun 1, 2016 Accepting new patients

Locations

4200 Division Ave N
Comstock Park, MI 49321
Phone (616) 252-1600

806 Alger St SE
Grand Rapids, MI 49507
Phone (616) 252-8923

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

Interoperability endpoints

  • Direct secure messaging: jgrzeszak868@direct.metrohealth.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1124083670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "address_2": "ATTN: MEDICAL ADMINISTRATION",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "164-528-9236",
            "fax_number": "616-452-9247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 ALGER ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495073803",
            "telephone_number": "616-252-7200",
            "fax_number": "616-452-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZESZAK",
        "first_name": "JOANNE",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101007147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.