Active NPI
Jeffrey J Ritsema, OD
- Optometrist
- Grand Rapids, MI
National Provider Identifier
1497731996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901002377
- Practice address
- 2112 East Paris Ave SE
Grand Rapids, MI 49546 - Phone
- (616) 949-8500
- Fax
- (616) 949-2878
- NPI assigned
- Dec 16, 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901002377 | MI | Primary |
Addresses
Primary practice location
2112 East Paris Ave SE
Grand Rapids, MI 49546
Mailing address
2112 East Paris Ave SE
Grand Rapids, MI 49546
Phone (616) 949-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| JR002377 | Other | MI | BLUECROSS |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481673600000",
"number": "1497731996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2112 EAST PARIS AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49546",
"telephone_number": "616-949-8500",
"fax_number": "616-949-2878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2112 EAST PARIS AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49546",
"telephone_number": "616-949-8500",
"fax_number": "616-949-2878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RITSEMA",
"first_name": "JEFFREY",
"middle_name": "J",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-16",
"last_updated": "2016-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901002377",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS",
"identifier": "JR002377",
"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 Dec 14, 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.