Individual provider Active NPI

Ai Yamasaki, MD

  • Pediatric Hospice and Palliative Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1376105122
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hospice and Palliative Medicine PhysicianTaxonomy code 2080H0002X
License
4301506968 Issued in MI
Practice address
25 Michigan St NE Ste 2100
Grand Rapids, MI 49503-2526
Phone
(616) 391-8842
Fax
(616) 391-2978
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301506968 MI
Pediatric Hospice and Palliative Medicine Physician 2080H0002X 4301506968 MI Primary

Addresses

Primary practice location

25 Michigan St NE Ste 2100
Grand Rapids, MI 49503-2526

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ayamasaki247310@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230519000787 MA Practitioner - Pediatric Medicine 6204164528 Reassigns benefits to 1 organization
I20250609001595 MI Practitioner - Pediatric Medicine 6204164528 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301506968MIMDPediatric Hospice and Palliative Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Pediatric Associates, Inc Pediatrics CurrentSince Jun 1, 2023 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 28, 2025 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 28, 2025 Accepting new patients
Children'S Hospital Corporation Past Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

35 Michigan St NE
Ste 4150
Grand Rapids, MI 49503
Phone (616) 267-2100

35 Michigan St NE
Ste 5301
Grand Rapids, MI 49503
Phone (616) 391-8842

35 Michigan St NE
Ste 5201
Grand Rapids, MI 49503
Phone (616) 267-2400

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

35 Michigan St NE
Ste 3003
Grand Rapids, MI 49503
Phone (616) 267-2200

35 Michigan St NE
Ste 1800
Grand Rapids, MI 49503
Phone (616) 267-0724

25 Michigan St NE
Ste 2100
Grand Rapids, MI 49503
Phone (616) 391-3777

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

330 Barclay Ave NE
Ste 300
Wyoming, MI 49503
Phone (616) 391-8806

Interoperability endpoints

  • Direct secure messaging: ayamasaki2611455@direct.trinity-health.org
  • Direct secure messaging: ayamasaki36982@direct.bostonchildrens.org
  • Direct secure messaging: ayamasaki247310@epic00.shdirect.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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1376105122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MICHIGAN ST NE STE 2100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032526",
            "telephone_number": "616-391-8842",
            "fax_number": "616-391-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMASAKI",
        "first_name": "AI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301506968",
            "primary": false
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "MI",
            "license": "4301506968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ayamasaki247310@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "35 Michigan St NE Ste 5301",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "35 Michigan St NE Ste 5301",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.