Individual provider Active NPI

Rafael Ernesto Ledesma Bilbao Jr., MD

  • Hospitalist Physician
  • Grand Rapids, MI
National Provider Identifier
1164565974
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
4301082270 Issued in MI
Practice address
200 Jefferson Ave SE Ste 626
Grand Rapids, MI 49503-4502
Phone
(616) 685-5576
Fax
(616) 685-8910
NPI assigned
Feb 14, 2007
Last updated
Apr 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 4301082270 MI Primary
Internal Medicine Physician 207R00000X 4301082270 MI

Addresses

Primary practice location

200 Jefferson Ave SE Ste 626
Grand Rapids, MI 49503-4502

Mailing address

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-5576

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rbilbao32596@direct.trinity-health.org Direct

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070326000416 MI Practitioner - HospitalistPractitioner - Family PracticePractitioner - Internal Medicine 1850495136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-5000

220 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5050

250 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Aug 1, 2013 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Aug 1, 2013 Accepting new patients
Saint Mary's Health Services Past Accepting new patients
Trinity Health - Michigan Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

1471 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 685-3414

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

200 Jefferson Ave SE
Ste 626
Grand Rapids, MI 49503
Phone (616) 685-5000

245 State St SE
Ste 1A
Grand Rapids, MI 49503

245 State St SE
Ste 221
Grand Rapids, MI 49503
Phone (616) 685-1808

260 Jefferson Ave SE
Ste 206
Grand Rapids, MI 49503
Phone (616) 752-5432

1900 44th St SE
Kentwood, MI 49508
Phone (616) 685-8500

Interoperability endpoints

  • Direct secure messaging: rbilbao32596@direct.trinity-health.org

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 4

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1164565974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-685-5576",
            "fax_number": "616-685-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE STE 626",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-685-5576",
            "fax_number": "616-685-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILBAO",
        "first_name": "RAFAEL",
        "middle_name": "ERNESTO LEDESMA",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301082270",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301082270",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbilbao32596@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Trinity Health Health Medical Group Hospitalist",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "office",
            "address_1": "200 Jefferson Ave SE Ste 626",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495034502",
            "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.