Justin Tyler Sybesma, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

4301083923 Issued in MI

Practice address

183 Peace Blvd
Saint Joseph, MI 49085-9146

Phone

(269) 428-3500

Fax

(269) 429-6429

NPI assigned

Oct 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Orthopedic Surgery

Education

Loma Linda University School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Michigan Center for Orthopaedic and Sports Medicine PGroup PAC ID 5890688444, 12 clinicians

Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Lakeland Hospitals St Joseph Hospital Home health agency, Benton Harbor, MI, CCN 237163
• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
• Corewell Health Watervliet Hospital Hospital, Watervliet, MI, CCN 230078

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsybesma1272245@epic00.shdirect.org
• Direct secure messaging: jsybesma13561@lakeland.midirect.net

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.

• Lakeland Medical Practices

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment Care Compare group NPD
• Southwest Michigan Center for Orthopaedic and Sports Medicine P

  • Specialist
  • Saint Joseph, MI
  • NPI 1104913094
  Medicare reassignment Care Compare group NPD
• Lakeland Medical Practices

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD
• Ascension Borgess Lee Hospital

  • Critical Access Hospital
  • Dowagiac, MI
  • NPI 1194771030
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeland Community Hospital Watervliet

  • General Acute Care Hospital
  • Watervliet, MI
  • NPI 1700994845
  Care Compare affiliation
• Lakeland Hospitals at Niles and St Joseph, Inc

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation
• Lakeland Hospitals at Niles and St Joseph, Inc

  • Home Health Agency
  • Benton Harbor, MI
  • NPI 1912094525
  Care Compare affiliation

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1376732016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 PEACE BLVD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859146",
            "telephone_number": "269-428-3500",
            "fax_number": "269-429-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 PEACE BLVD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859146",
            "telephone_number": "269-428-3500",
            "fax_number": "269-429-6429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYBESMA",
        "first_name": "JUSTIN",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-18",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301083923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376732016",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2003901922",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jared Sustad, DO
• Sutinderpal Judge M.D., PC
• Madeline Svec
• Auburn Skakle Swainston
• Richard T. Swanson, M.D.
• Renata Sykula
• Dennis C Szymanski, M.D.
• T N B Family Counseling PLLC
• Douglas Gregory Tacket, D.O.
• Karanvir Singh Takhar, DO

• Orthopaedic Surgery Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.

Verify at the official NPI Registry.