Individual provider Active NPI

Ryan Marin, MD

  • Psychiatry Physician
  • Grand Rapids, MI
National Provider Identifier
1174787543
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01070160A Issued in IN
Practice address
100 Michigan St NE
Mc215
Grand Rapids, MI 49503-2560
Phone
(616) 486-9155
Fax
(616) 486-6938
NPI assigned
Jul 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01070160A IN Primary

Addresses

Primary practice location

100 Michigan St NE
Mc215
Grand Rapids, MI 49503-2560

Mailing address

100 Michigan St NE
Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

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
I20130828001031 MI Practitioner - PsychiatryPractitioner - Neurology 4688845811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Michigan State University College of Human Medicine, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01070160AINMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Physicians Network of Michigan Psychiatry CurrentSince Oct 11, 2025 Accepting new patients
Indiana University Psychiatric Associates, Inc. Psychiatry PastSince Dec 18, 2003 Accepting new patients

Locations

6291 Venture Hills Blvd SW
Byron Center, MI 49315
Phone (616) 362-0300

101 W Townsend Rd
Saint Johns, MI 48879
Phone (989) 403-6022

Organizations & group practices 2

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1174787543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC215",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-9155",
            "fax_number": "616-486-6938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01070160A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.