Individual provider Active NPI

Jesse Myers

  • Diagnostic Radiology Physician
  • Midland, MI
National Provider Identifier
1205120045
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301110318 Issued in MI
Practice address
4005 Orchard Dr
Midland, MI 48670-2001
Phone
(989) 839-3408
NPI assigned
Jun 8, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.059533 IL
Diagnostic Radiology Physician 2085R0202X 5315077054 MI
Diagnostic Radiology Physician 2085R0202X 4301110318 MI Primary

Addresses

Primary practice location

4005 Orchard Dr
Midland, MI 48670-2001

Mailing address

4005 Orchard Dr
Midland, MI 48670-2001
Phone (989) 839-3408

Other practice location 1

3601 W 13 Mile Rd
Royal Oak, MI 48073
Phone (248) 898-6091

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
I20170705000170 MI Practitioner - Diagnostic Radiology 1254632433 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.4 of 100Reported as group
Quality
66.97
Promoting interoperability
100
Improvement activities
40
Cost
75.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.059533ILMDInternal Medicine Physician
5315077054MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hurley Medical Center CurrentSince Apr 1, 2023 Accepting new patients
Midland Radiology Associates PC Diagnostic Radiology CurrentSince Jul 1, 2017 Accepting new patients
Hurley Medical Center Diagnostic Radiology CurrentSince Apr 1, 2023 Accepting new patients
Hurley Medical Center Current Accepting new patients

Locations

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

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

4005 Orch Dr
Midland, MI 48670
Phone (989) 839-3100

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.

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205120045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 ORCHARD DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702001",
            "telephone_number": "989-839-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 ORCHARD DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702001",
            "telephone_number": "989-839-3408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "48073",
            "country_code": "US",
            "telephone_number": "248-898-6091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYERS",
        "first_name": "JESSE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.059533",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5315077054",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301110318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.