Individual provider Active NPI

Brian P Giersch, MD

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
National Provider Identifier
1366455677
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
BG073347 Issued in MI
Practice address
3350 Eagle Park Dr NE
Suite 108
Grand Rapids, MI 49525-4570
Phone
(616) 458-1088
Fax
(616) 458-7809
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X BG073347 MI Primary

Addresses

Primary practice location

3350 Eagle Park Dr NE
Suite 108
Grand Rapids, MI 49525-4570

Mailing address

3350 Eagle Park Dr NE
Suite 108
Grand Rapids, MI 49525-4570
Phone (616) 458-1088

Other identifiers 2

IdentifierTypeStateIssuer
3505509MedicaidMI
RR250010074OtherMIMEDICARE RR

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
I20050719000500 MI Practitioner - Physical Medicine and Rehabilitation 1456388735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Loyola University of Chicago, Stritch School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3350 Eagle Park Dr NE
Grand Rapids, MI 49525-4570
Phone (616) 458-1088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BG073347MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Medicine Associates,PLC Physical Medicine & Rehabilitation CurrentSince Dec 1, 1998 Accepting new patients

Locations

3350 Eagle Park Dr NE
Ste 108
Grand Rapids, MI 49525
Phone (616) 458-1088

Organizations & group practices 1

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1366455677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 EAGLE PARK DR NE",
            "address_2": "SUITE 108",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254570",
            "telephone_number": "616-458-1088",
            "fax_number": "616-458-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 EAGLE PARK DR NE",
            "address_2": "SUITE 108",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254570",
            "telephone_number": "616-458-1088",
            "fax_number": "616-458-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIERSCH",
        "first_name": "BRIAN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "BG073347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3505509",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "RR250010074",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.