Zachary Hartley-Blossom, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4301508654 Issued in MI

Practice address

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746

Phone

(616) 363-7272

Fax

(616) 361-5828

NPI assigned

Jun 7, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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

Specialty

Diagnostic Radiology

Education

Oakland Univ, William Beaumont School of Medicine, 2017

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)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
• Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
• Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
• Mymichigan Medical Center Clare Hospital, Clare, MI, CCN 230180

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zhartleyblossom1131558@direct.hfhs.org
• Direct secure messaging: hartley-blossom.zachary.mgh@direct.partners.masshiway.net

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.

• Advanced Radiology Services PC

  • Diagnostic Radiology Physician
  • Grand Rapids, MI
  • NPI 1740283324
  Medicare reassignment Care Compare group NPD
• Metropolitan Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment NPD
• General Hospital Corp

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1508390014
  NPD
• Metropolitan Hospital

  • Family Medicine Physician
  • Wyoming, MI
  • NPI 1114947538

  Surgery

  NPD (past)
• Metropolitan Hospital

  • Anatomic Pathology & Clinical Pathology Physician
  • Wyoming, MI
  • NPI 1336182542
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bronson Methodist Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1831116441
  Care Compare affiliation
• Lakeland Hospitals at Niles and St Joseph, Inc

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation
• Mymichigan Medical Center Clare

  • General Acute Care Hospital
  • Clare, MI
  • NPI 1568414589
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490

  Hospital

  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1376973149
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1902841414
  Care Compare affiliation
• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1225567902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "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 DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-726-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Metro Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028861768",
            "country_code": "US",
            "telephone_number": "140-192-1920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-5174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTLEY-BLOSSOM",
        "first_name": "ZACHARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD17244",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "290918",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "LP04037",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301508654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI MD LICENSE",
            "identifier": "MD17244",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Hartert
• Kimberly Hartger
• Jacob Ivan Hartig, CRNA
• Kaitlyn Hartl
• James Hartlein
• Allison Hartley
• Philip Hartley
• Ryan Hartley, DMD
• Anthony Hartman
• Kate Hartman, PA-C

• Diagnostic Radiology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.