Individual provider Active NPI

Bryan S Judge, MD

  • Medical Toxicology (Emergency Medicine) Physician
  • Grand Rapids, MI
National Provider Identifier
1255348173
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Toxicology (Emergency Medicine) PhysicianTaxonomy code 207PT0002X
License
4301072294 Issued in MI
Practice address
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone
(616) 391-1680
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301072294 MI
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 4301072294 MI
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X 4301072294 MI
Medical Toxicology (Emergency Medicine) Physician 207PT0002X 4301072294 MI Primary

Addresses

Primary practice location

100 Michigan St NE
Grand Rapids, MI 49503-2560

Mailing address

4100 Embassy Dr SE Ste 400
Grand Rapids, MI 49546-2416
Phone (616) 975-1845

Other practice location 1

1840 Wealthy St SE
Grand Rapids, MI 49506-2921
Phone (616) 391-1774

Other practice location 2

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (616) 975-1845

Other identifiers 3

IdentifierTypeStateIssuer
930125251OtherMIRAILROAD MEDICARE
1255348173MedicaidMI
P00643475OtherMIRAILROAD MEDICARE

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
I20070320000082 MI Practitioner - Emergency Medicine 9436252079 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wayne State University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Visionary Medical Services, PCGroup PAC ID 1951404185, 63 clinicians
Ecs Western Michigan PCGroup PAC ID 8628327384, 202 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 391-1730

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Aspirus Keweenaw Hospital and Clinics Hospital, Laurium, MI, CCN 231319

Merit-based Incentive Payment System (MIPS)

Final score
97.48 of 100Reported as group
Quality
89.26
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301072294MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ecs Western Michigan PC Anesthesiology CurrentSince Aug 1, 2018 Accepting new patients
Aspirus Keweenaw Current Accepting new patients
Rightcare Clinic PC CurrentSince Oct 31, 2024 Accepting new patients
Visionary Medical Services PC Anesthesiology CurrentSince Jan 1, 2007 Accepting new patients
Emergency Medical Group, Inc. Medical Toxicology Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

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

1840 Wealthy St SE
Grand Rapids, MI 49506
Phone (616) 391-1730

743 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 456-9553

4100 Embassy Dr SE
Ste 400
Grand Rapids, MI 49546
Phone (616) 285-8075

615 S Bower St
Greenville, MI 48838
Phone (616) 754-4341

205 Osceola St
Laurium, MI 49913
Phone (906) 337-3100

Organizations & group practices 6

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 5

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1255348173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 EMBASSY DR SE STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462416",
            "telephone_number": "616-975-1845",
            "fax_number": "616-285-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-1680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1840 Wealthy St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495062921",
            "country_code": "US",
            "telephone_number": "616-391-1774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Michigan St NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032560",
            "country_code": "US",
            "telephone_number": "616-975-1845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUDGE",
        "first_name": "BRYAN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301072294",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301072294",
            "primary": false
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "MI",
            "license": "4301072294",
            "primary": false
        },
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "MI",
            "license": "4301072294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930125251",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255348173",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00643475",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.