NPIMap

Individual provider Active NPI

Gerard Farrar, MD

  • Neuroradiology Physician
  • Grand Rapids, MI
National Provider Identifier
1174543102
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
GF407494 Issued in MI
Practice address
3264 N Evergreen Drive NE
Grand Rapids, MI 49525
Phone
(616) 363-7272
Fax
(616) 361-5828
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X GF407494 MI
Neuroradiology Physician 2085N0700X GF407494 MI Primary

Addresses

Primary practice location

3264 N Evergreen Drive NE
Grand Rapids, MI 49525

Mailing address

3264 N Evergreen Drive NE
Grand Rapids, MI 49525
Phone (616) 363-7272

Other identifiers 2

IdentifierTypeStateIssuer
1174543102MedicaidMI
300E676040OtherMIBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050808000038 MI Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 9335045715 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Wayne State University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Radiology Services PCGroup PAC ID 4284546516, 252 clinicians

Practice addresses (Care Compare)

700 Cooper Ave
Saginaw, MI 48602-5383
Phone (616) 363-7272

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
GF407494MIMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Radiology Services PC CurrentSince Jan 1, 2022 Accepting new patients
Covenant Medical Center, Inc CurrentSince May 21, 2013 Accepting new patients
Covenant Medical Center, Inc. CurrentSince May 21, 2013 Accepting new patients
Covenant Medical Center, Inc. Current Accepting new patients
Midland Radiology Associates PC Past Accepting new patients
Mymichigan Medical Center Midland Past Accepting new patients
Saginaw Valley Neurosurgery, P.L.L.C. Past Accepting new patients
Mymichigan Medical Center Gladwin Past Accepting new patients
Midland Radiology Associates PC Past Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

3264 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 391-6001

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

700 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6000

3400 N Center Rd
Ste 400
Saginaw, MI 48603
Phone (989) 799-5600

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

Interoperability endpoints

  • Direct secure messaging: gfarrar33013@direct.covenanthealthcare.com
  • Direct secure messaging: gfarrar1126573@direct.hfhs.org

Organizations & group practices 10

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 8

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1174543102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DRIVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DRIVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRAR",
        "first_name": "GERARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MI",
            "license": "GF407494",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MI",
            "license": "GF407494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174543102",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "300E676040",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.