David Tetsuji Ishiyama, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301096372 Issued in MI

Practice address

1000 Monroe Ave NW
Grmep
Grand Rapids, MI 49503-1455

Phone

(616) 391-8879

NPI assigned

Jun 19, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Emergency Medicine

Education

Michigan State University College of Human Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independent Emergency Physicians PCGroup PAC ID 6709798325, 173 clinicians

Iep Observation Medicine - Jackson PLLCGroup PAC ID 6800234592, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dishiyama451664@direct.hfhs.org

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.

• Iep Observation Medicine - Jackson PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Jackson, MI
  • NPI 1982478251
  Medicare reassignment Care Compare group NPD
• Independent Emergency Physicians, P.C.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1780791343
  Medicare reassignment Care Compare group NPD
• Independent Observation Physicians PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1700119500
  Medicare reassignment NPD
• Wa Foote Memorial Hospital, Inc

  • Emergency Medicine Physician
  • Jackson, MI
  • NPI 1265487722
  Medicare reassignment NPD
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD

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

• W.a. Foote Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1276905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369958400000",
    "number": "1407177884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44650 DANBURY RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481881050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONROE AVE NW",
            "address_2": "GRMEP",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031455",
            "telephone_number": "616-391-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHIYAMA",
        "first_name": "DAVID",
        "middle_name": "TETSUJI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-19",
        "last_updated": "2013-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301096372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet Lynn Isabell, RNC
• Jackeline Iseler, ACNS-BC
• Lindsay Grace Isenhart, DDS
• Isethena Press LLC
• Katherine Claire Isetts
• Mirna Iskander
• Ismail B. Sendi, MD, PC
• Ali Ismail, MD
• Inara Ismailova, MD, MPH
• Mathea Kennedy Ismond, BSW

• Emergency Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; 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.