Individual provider Active NPI

John M Dysart, MD

  • Pediatric Cardiology Physician
  • Lansing, MI
National Provider Identifier
1265425177
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
JD063672 Issued in MI
Practice address
3220 Discovery Drive
Suite 210
Lansing, MI 48910
Phone
(517) 484-0004
Fax
(517) 484-7241
NPI assigned
Aug 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X JD063672 MI Primary
Specialist 174400000X

Addresses

Primary practice location

3220 Discovery Drive
Suite 210
Lansing, MI 48910

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
L3338287MedicaidMI
85305OtherMIBLUE CARE NETWORK

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
I20090527000223 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 2466501200 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Medical College of Georgia School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

802 W King St FL 2 K
Corewell Health Medical Group West
Owosso, MI 48867-2100
Phone (517) 484-0004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
JD063672MIMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jul 1, 2013 Accepting new patients
Spectrum Health Primary Care Partners Pediatric Cardiology CurrentSince Jul 1, 2013 Accepting new patients
Spectrum Health Hospitals Pediatric Cardiology CurrentSince Sep 1, 2017 Accepting new patients
Spectrum Health Hospitals CurrentSince Sep 1, 2017 Accepting new patients

Locations

8273 S Saginaw St
Grand Blanc, MI 48439
Phone (810) 579-7184

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

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

3220 Discovery Dr
Ste 210
Lansing, MI 48910
Phone (517) 484-0004

1514 E Michigan Ave
Lansing, MI 48912
Phone (517) 484-0004

3960 Patient Care Dr
Ste 113
Lansing, MI 48911
Phone (517) 702-3200

Interoperability endpoints

  • Direct secure messaging: jdysart20623@epic00.corewelldirect.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1265425177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 DISCOVERY DRIVE",
            "address_2": "SUITE 210",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48910",
            "telephone_number": "517-484-0004",
            "fax_number": "517-484-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYSART",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MI",
            "license": "JD063672",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L3338287",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "85305",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.