NPIMap

Organization Active NPI

Orthopaedic Associates of Grand Rapids, PC

  • Durable Medical Equipment & Medical Supplies
  • Grand Rapids, MI
National Provider Identifier
1154761773
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ORTHOPAEDIC ASSOCIATES OF GRAND RAPIDS, PC
Practice address
555 Midtowne St NE Ste 105
Grand Rapids, MI 49503-5731
Phone
(616) 459-7101
NPI assigned
Jun 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Authorized official

Name
Brian Murray
Title
Chief Financial Officer
Phone
(616) 459-7101

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

555 Midtowne St NE Ste 105
Grand Rapids, MI 49503-5731

Mailing address

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone (616) 459-7101

Other identifiers 1

IdentifierTypeStateIssuer
OD14869OtherMIPTAN

Other names 1

  • Orthopaedic Associates of Michigan, PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131007000721 MI DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Independently-Practicing Physical Therapist 9537136403 Practice locations: Grand Rapids, MI

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 86

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 86

NPI Registry JSON

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1154761773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-459-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE ST NE STE 105",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035731",
            "telephone_number": "616-459-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC ASSOCIATES OF GRAND RAPIDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-27",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "616-459-7101"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "OD14869",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthopaedic Associates of Michigan, PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orthopaedic Associates of Michigan, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.