Individual provider Active NPI

Joel Zembles, CAA

  • Anesthesiologist Assistant
  • Grand Rapids, MI
National Provider Identifier
1316578628
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone
(616) 364-4200
NPI assigned
Jan 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 157-17 WI
Anesthesiologist Assistant 367H00000X MI Primary

Addresses

Primary practice location

100 Michigan St NE
Grand Rapids, MI 49503-2560

Mailing address

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Phone (616) 364-4200

Other practice location 1

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Phone (616) 364-4200

Other identifiers 1

IdentifierTypeStateIssuer
100097230MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jzembles353083@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240730004211 MI Practitioner - Anesthesiology Assistant 0749616704 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Medical College of Wisconsin, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Michigan Anesthesia PCGroup PAC ID 1355243551, 69 clinicians
Anesthesia Medical Consultants, PCGroup PAC ID 3678751658, 87 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

3333 Evergeen Dr NE
Grand Rapids, MI 49525-9493
Phone (616) 364-4200

5900 Byron Ctr Ave SW
Metro Health Hospital
Wyoming, MI 49519-9606
Phone (616) 364-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
157-17WIMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Anesthesia, PC CurrentSince Aug 1, 2024 Accepting new patients
Anesthesia Medical Consultants, PC CurrentSince Aug 1, 2024 Accepting new patients

Locations

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

3333 Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 284-3132

4055 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 252-4410

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Organizations & group practices 2

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": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1316578628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259493",
            "telephone_number": "616-364-4200"
        },
        {
            "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": "616-364-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Evergreen Dr NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495259493",
            "country_code": "US",
            "telephone_number": "616-364-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEMBLES",
        "first_name": "JOEL",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-27",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "WI",
            "license": "157-17",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100097230",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jzembles353083@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2516 Commonwealth Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537111913",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2516 Commonwealth Ave",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537111913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.