Active NPI
Mohammad Javad Poostizadeh, MD
- Clinical Neurophysiology Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neurophysiology Physician
- License
- 4301104031
- Practice address
- 245 Cherry St SE
Ste 104
Grand Rapids, MI 49503 - Phone
- (616) 685-8620
- NPI assigned
- Jan 1, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Neurophysiology Physician | 2084N0600X | 4301104031 | MI | Primary |
Addresses
Primary practice location
245 Cherry St SE
Ste 104
Grand Rapids, MI 49503
Mailing address
1900 44TH St SE
Kentwood, MI 49508
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850
200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone (616) 685-5000
220 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5050
250 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301104031 | MI | MD | Clinical Neurophysiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Partners - Physician Specialist | Current | Accepting new patients | |
| Advantage Health Saint Mary's Medical Group | Current | Accepting new patients | |
| Advantage Health Saint Mary's Medical Group | Current | Accepting new patients | |
| Advantage Health/Saint Mary's Medical Group | Current | Accepting new patients | |
| Saint Mary's Health Services | Past | Accepting new patients |
Locations
10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850
245 Cherry St SE
Ste 104
Grand Rapids, MI 49503
Phone (616) 774-6337
1900 44th St SE
Kentwood, MI 49508
Phone (616) 685-8500
1675 Leahy St
Ste 401A
Muskegon, MI 49442
Phone (231) 672-4243
1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027
Interoperability endpoints
- mpoostizadeh36237@direct.trinity-health.org
Organizations & group practices 5
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.
-
dba Trinity Health Medical Group
- Multi-Specialty Clinic/Center
- Grand Rapids, MI
- NPI 1376862151
-
dba Trinity Health Medical Group
- Internal Medicine Physician
- Muskegon, MI
- NPI 1922248772
-
dba Trinity Health Medical Group Orthopedics Grand Rapids
- Orthopaedic Surgery Physician
- Byron Center, MI
- NPI 1003515008
-
dba Trinity Health Medical Group
- Multi-Specialty Clinic/Center
- Grand Rapids, MI
- NPI 1952340911
-
dba Mercy Health Saint Mary's
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1639111057
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Mercy Health Muskegon
- General Acute Care Hospital
- Muskegon, MI
- NPI 1831132133
-
dba Mercy Health Saint Mary's
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1639111057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391040000000",
"number": "1417193087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 44TH ST SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "49508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 CHERRY ST SE",
"address_2": "STE 104",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49503",
"telephone_number": "616-685-8620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POOSTIZADEH",
"first_name": "MOHAMMAD",
"middle_name": "JAVAD",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-01",
"last_updated": "2014-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0600X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": "MI",
"license": "4301104031",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jan 30, 2014; 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.