Active NPI
David J Bielema, MD
- Orthopaedic Surgery Physician
- Grand Rapids, MI
National Provider Identifier
1447248588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 4301052961
- Practice address
- 555 Midtowne St NE
Suite 105
Grand Rapids, MI 49503-5729 - Phone
- (616) 459-7101
- Fax
- (616) 464-6170
- NPI assigned
- Oct 12, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 4301052961 | MI | Primary |
Addresses
Primary practice location
555 Midtowne St NE
Suite 105
Grand Rapids, MI 49503-5729
Mailing address
1111 Leffingwell Ave NE
Ste 100
Grand Rapids, MI 49525-6406
Phone (616) 459-7101
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200017183 | Other | RR MEDICARE | |
| 2913025 | Medicaid | MI | |
| 102913025 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Interoperability endpoints
- dbielema237@direct.metrohealth.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467072000000",
"number": "1447248588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 LEFFINGWELL AVE NE",
"address_2": "STE 100",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495256406",
"telephone_number": "616-459-7101",
"fax_number": "616-464-6170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 MIDTOWNE ST NE",
"address_2": "SUITE 105",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495035729",
"telephone_number": "616-459-7101",
"fax_number": "616-464-6170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIELEMA",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-12",
"last_updated": "2016-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MI",
"license": "4301052961",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "200017183",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2913025",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102913025",
"state": "MI"
}
],
"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 Jun 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.