Active NPI
Derek Blok, MD
- Sports Medicine (Emergency Medicine) Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Emergency Medicine) Physician
- License
- 4301119280
- Practice address
- 2770 E Beltline Ave NE
Grand Rapids, MI 49525-8614 - Phone
- (616) 267-8741
- NPI assigned
- Jun 30, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 4301119280 | MI | |
| Sports Medicine (Emergency Medicine) Physician | 207PS0010X | 4301119280 | MI | Primary |
Addresses
Primary practice location
2770 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Mailing address
4100 Lake Dr SE Ste 300
Grand Rapids, MI 49546-8292
Phone (616) 267-8741
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190907000031 | MI | Practitioner - Emergency Medicine | 5193095396 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Wayne State University School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115
2750 E Beltline Ave NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-8614
Phone (616) 267-8950
2750 E Beltline Ave NE FL
Grand Rapids, MI 49525-8614
2770 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Phone (616) 267-8860
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
588 E Lakewood Blvd FL
Holland, MI 49424-2023
Hospital & facility affiliations
- Spectrum Health
- Holland Hospital
- Corewell Health Zeeland Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301119280 | MI | MD | Sports Medicine (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Internal Medicine | Current | Accepting new patients |
| Spectrum Health Primary Care Partners | Internal Medicine | Current | Accepting new patients |
| Spectrum Health Primary Care Partners | Internal Medicine | Current | Accepting new patients |
Locations
212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212
2770 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-8860
100 Michigan St NE
#49
Grand Rapids, MI 49503
Phone (616) 391-1680
4100 Lake Dr SE
Ste 300
Grand Rapids, MI 49546
Phone (616) 267-8860
100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680
615 S Bower St
Greenville, MI 48838
Phone (616) 754-4341
588 E Lakewood Blvd
Fl 1
Holland, MI 49424
Phone (616) 494-5800
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
Interoperability endpoints
- dblok156887@epic00.corewelldirect.org
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
Internal Medicine, MI
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1689499667
Internal Medicine
-
- Hospitalist Physician
- Grand Rapids, MI
- NPI 1790093763
Internal Medicine
Hospital & facility affiliations 4
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": "1498780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1306367230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 LAKE DR SE STE 300",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495468292",
"telephone_number": "616-267-8741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2770 E BELTLINE AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495258614",
"telephone_number": "616-267-8741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOK",
"first_name": "DEREK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-30",
"last_updated": "2024-11-05",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "4301119280",
"primary": false
},
{
"code": "207PS0010X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Sports Medicine",
"state": "MI",
"license": "4301119280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.