Gilbert A Masterson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301062800 Issued in MI

Practice address

1179 East Paris Ave SE Ste 100
Grand Rapids, MI 49546-3682

Phone

(616) 690-2690

Fax

(616) 360-2034

NPI assigned

Sep 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Psychiatry

Education

Loma Linda University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lifeline Interventional Therapeutics, PLLC

  • Psychiatry Physician
  • Grand Rapids, MI
  • NPI 1912726811

  Addiction Medicine

  Medicare reassignment NPD
• Psychiatry Specialists of Grand Rapids, PLLC

  • Certified Registered Nurse Anesthetist
  • Grand Rapids, MI
  • NPI 1710638960

  Psychiatry

  Medicare reassignment NPD
• Lafayette Medical Specialists PLLC

  • Addiction Medicine (Internal Medicine) Physician
  • Marne, MI
  • NPI 1598437642

  Psychiatry

  NPD

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1497740930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1179 EAST PARIS AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463682",
            "telephone_number": "616-690-2690",
            "fax_number": "616-360-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 EAST PARIS AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463682",
            "telephone_number": "616-690-2690",
            "fax_number": "616-360-2034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "540 Cherry St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034748",
            "country_code": "US",
            "telephone_number": "844-776-9651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15146 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Marne",
            "state": "MI",
            "postal_code": "494359605",
            "country_code": "US",
            "telephone_number": "616-520-9075",
            "fax_number": "616-341-6013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "221 John St NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495033237",
            "country_code": "US",
            "telephone_number": "844-776-9651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "GILBERT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MI",
            "license": "4301062800",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-127636",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301062800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4305173",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jayce Christopher Masters
• Margaret Masters, NP-C
• Nicholas Masters
• Caitlin Elizabeth Masterson, M.S., OTR/L
• Chloe Casanave Masterson, PHARMD
• Alison Mastin
• Julie Mata, LLBSW
• Ruth Mata
• Thomas M Matelic, MD
• Jesmarie Yoli Mateo

• Psychiatry Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.